Minnesota Maternity Care: Attorney General Launches Rural Health Initiative

Rural hospitals in Minnesota face increasing financial strain due to federal Medicaid reductions. In response, state officials have moved to protect access to maternity services in these communities.

Minnesota Attorney General Keith Ellison announced a new statewide project on Wednesday, October 28, designed to strengthen rural maternal healthcare. The initiative, titled "Strengthening Rural Maternal Healthcare in Minnesota," will assess current services and project future conditions under the new federal funding rules.

The project will compare local capabilities against national and global standards for safe access to labor and delivery, prenatal, and postnatal care. It will then propose collaborative solutions to address identified gaps.

Kent Mattson, CEO and President of Lake Region Healthcare, spoke at the announcement. He noted that while his organization values local ownership, the future of rural care depends on strong partnerships. Mattson highlighted the role of larger partners like Sanford Health in connecting rural patients to specialized expertise.

"We do know that the future of rural healthcare rests on strong collaboration," Mattson said. "Over decades, we've worked to partner with larger care partners across our region, across the state, in particular, Sanford Health, which is part of the care system in our communities and the region that we serve."

Ellison's office cites research linking longer travel distances to labor and delivery centers with higher rates of complications. These complications include the need for blood transfusions or emergency surgery. Conversely, hospitals with very low birth volumes also carry higher risks of severe maternal morbidity. The project seeks to balance proximity to services with adequate clinical capacity.

Since 2010, Minnesota has lost more than 20% of its hospital-based obstetric services, making it one of only seven states with that level of decline. Despite this, more than half of the state's counties still have at least one hospital with obstetrics services. The Attorney General's Office estimates that over 700,000 Minnesotans live in counties without labor and delivery services. Additionally, about 67,000 women of childbearing age live more than a half-hour from a delivery unit.

Lois Quam, the Attorney General's strategic facilitator, will lead the project. Quam, who grew up in Marshall, will convene an initial meeting before the end of 2026. This meeting will define the project's scope, timeline, and goals. Public town hall meetings are anticipated, and a report with recommendations is scheduled for release in 2027.

The initiative follows Sanford Health's acquisition of North Memorial Health, which closed on September 1. The two systems signed a 10-year oversight agreement with the Attorney General's Office. Under that deal, Sanford committed $600 million in investments to North Memorial, including $500 million for Maple Grove Hospital and $100 million for Robbinsdale Hospital. The agreement also requires preserving Robbinsdale's Level 1 trauma center for at least a decade.