WA hospitals close labor and delivery units, raising fears for new parents

Emma Argo of Toppenish had planned to deliver her third child at Astria Toppenish Hospital, but it closed four months before her due date. After the closure, Argo said she felt an “emotional toll.”

The state’s decision to raise Medicaid reimbursement rates for Astria Toppenish Hospital comes too late to save Astria’s Family Maternity Center, but it’s still welcome news.

Under a bill signed into law May 11 by Gov. Jay Inslee, the state will begin reimbursing inpatient visits by Medicaid patients at 120%, while reimbursing outpatient visits at 200%. Meantime, the state’s giving Astria $4 million in distressed hospital funding to help cover the nonprofit’s costs until the higher rates take effect this July.

Considering the scarcity of health care in the Lower Valley, it’s not hyperbole to say that the bill, sponsored by state Sen. Curtis King, R-Yakima, could be a life-saver.

“With the governor’s signature on this bill today,” King said, “the Astria Toppenish Hospital will be on solid financial ground instead of being at risk of closing.”

We hope that turns out to be the case.

Astria’s 63-bed hospital in Toppenish is essential to thousands of Lower Valley residents, who would be miles away from critical care if the hospital were to close.

Despite that, its relatively small size means it doesn’t qualify for designation as a critical access hospital. Such hospitals — including Astria Sunnyside and Prosser Memorial — are eligible for state Medicaid reimbursement rates closer to the 150% range.

Astria has lobbied long and hard for higher reimbursements for its Toppenish hospital, but the company hasn’t prevailed until now.

Instead, the state reduced reimbursements at the hospital last year, which Astria officials say was a key factor in their decision to close the Family Maternity Center in Toppenish in January.

Maybe Astria’s leaders weren’t making a persuasive enough case for themselves. Maybe state leaders just weren’t seeing the seriousness of Toppenish’s situation.

Or maybe Astria has made some financial missteps. The maternity center lost $3.2 million in its final year, according to Astria, which in 2020 closed its regional medical center in Yakima.

“We performed herculean efforts to sustain our beloved maternity center, but unfortunately, due to rising costs, labor storages and a significant reduction in Medicaid reimbursement, we’re unable to keep it open,” Toppenish Hospital Administrator Cathy Bambrick said in December 2022.

Whatever the case, it was a painful blow, adding the Toppenish community to an alarming statistic recently reported by the Center for Healthcare Quality & Payment Reform: Less than half (46%) of rural hospitals offer labor and delivery care anymore.

Whether you’re out to protect or tear away any remaining access women have to maternal care, a statistic like that means many local women — mothers, daughters, sisters, wives — face greater risks of dying than they did just a few years ago. A lack of prenatal and maternal care makes childbirth a much dicier proposition — and if it takes half an hour or more to get to a health care provider, mothers’ and babies’ lives could be on the line.

Sen. King’s legislation won’t solve all of the Lower Valley’s health care needs. But by all accounts, it should at least keep Astria Toppenish Hospital stable for the next few years.

Meantime, Toppenish-area voters will consider a proposal on the Aug. 1 ballot to form a hospital tax district, which backers hope could restore desperately needed local maternity care.

Those are encouraging developments for the Lower Valley.

And at a time of worrisome uncertainty for rural health care, we’ll take all the good news we can get.

Yakima Herald-Republic editorials reflect the collective opinions of the newspaper’s local editorial board.