Hospitals Must Disclose Premature Birth Policies by 2026 or Risk Losing Medicaid Funding

The “Neonatal Care Transparency Act of 2025” is designed to peel back the curtain on a life-or-death question: When it comes to extremely premature babies, how early is too early for a hospital to try and save them? This bill mandates that hospitals and the doctors who deliver babies must clearly state their policy regarding life-saving care for infants born before a specific gestational age, particularly those under 22 weeks. Starting January 1, 2026 (Section 4), this information has to be public, and your doctor has to tell you about it at your very first prenatal appointment (Section 3).

The Fine Print on Premature Care

The core of this legislation is the recognition that not all NICUs are created equal. The bill’s findings state that some hospitals won't attempt to save a baby born before 22 weeks, while others will try to help every baby born alive. To fix this information gap, hospitals must publicly post whether they have a minimum gestational age threshold for providing intensive, life-saving care. If they do, they have to state it clearly. If they decide treatment on a case-by-case basis, they must disclose that process instead (Section 3(a)). This is crucial for parents facing high-risk pregnancies—it gives them the ability to make informed decisions about where they plan to deliver, potentially moving to a facility with more aggressive policies if needed.

Your Doctor Has to Talk

This isn't just a hospital administrative task. The bill puts the onus on your obstetrician or practitioner as well. At that very first prenatal visit, your doctor must disclose the specific policy of any hospital where they have admitting privileges regarding life-saving care for premature infants. They also have to explain the hospital’s procedure for transferring both you and the baby to the nearest facility that can provide the necessary NICU care, should their hospital not be equipped to handle it (Section 3(b)). For busy expecting parents, this means getting critical, specific information early on, rather than scrambling for facts during a crisis.

The Medicaid Hammer: Enforcement Kicks In

The transparency requirements are backed by a serious financial threat. Section 5 states that 180 days after the Act becomes law, the federal government will stop providing Medicaid and CHIP funding for services provided by any hospital or obstetric provider that fails to meet these new disclosure rules. Essentially, if a hospital or doctor doesn't comply with the transparency mandate, they can lose a critical source of federal funding. For hospitals, especially those serving large Medicaid populations or located in rural areas, this is a massive penalty for an administrative failure.

Real-World Stakes for Patients and Providers

For patients, this bill is a net positive for informed consent. If you’re a parent in a high-risk situation, you now have the right to know exactly what kind of care your hospital offers before you need it. However, the enforcement mechanism in Section 5 raises practical concerns. Losing Medicaid/CHIP funding is a massive blow that could force a hospital to cut services or even close. If a rural hospital, for example, struggles to meet the administrative burden of the new disclosure rules and loses its funding, the patients relying on that facility—often low-income families—could lose access to care entirely. The intent is transparency, but the penalty for non-compliance is severe and could inadvertently harm the very people the system is meant to serve.