Dozens of OB-GYNs fled Idaho after its abortion ban. Medicaid cuts could make access to care even worse.

essentialsaltes · Wednesday at 7:21 PM

Dozens of OB-GYNs fled Idaho after its abortion ban. Medicaid cuts could make access to care even worse.

The state has lost over a third of its OB-GYNs -- 94 of 268 -- since the ban was enacted in 2022, according to a new study in medical journal JAMA Network Open.

[A year ago, they had 'only' lost 22% of them.]

essentialsaltes said:
Idaho doctor who worked at now-closed maternity ward says abortion ban harmed recruiting
West Valley Medical Center is the third facility to close its maternity services in Idaho since the state enacted a near-total abortion ban in August 2022.

A February report by a coalition of Idaho physicians found the state lost 22% of practicing OB-GYNs since the ban took effect, and 55% of maternal-fetal medicine specialists.

After Bonner General closed its obstetric services, Kootenai Health, located an hour south, inherited its patients, which included residents across the northern tip of the state. Some women now have to drive two to three hours to get prenatal care or to deliver at Kootenai, according to one of its OB-GYNs, Dr. Brenna McCrummen.

"There have been patients that have delivered on the side of the road because they're not able to get to the hospital in time. There have been babies that have gone to the NICU who didn't do as well as they probably would have had they not had to travel long distances," she told ABC News.

More than 350,000 of the state's residents are insured by Medicaid, including those covered by the expansion plan voters approved through a ballot measure in 2018.

Under the federal changes, the state could lose $3 billion in funding over the next decade and 37,000 residents could lose coverage, according to analysis by KFF.

In Idaho, Medicaid covers around a third of births, according to data from March of Dimes.

"The worry is that as these changes are happening in the Medicaid space, it's going to be harder, particularly for rural hospitals, to maintain those obstetric services, and if they discontinue those, we've got more maternity care deserts, and we've got a greater risk of both moms and babies having worse outcomes," Warren said.

"If patients don't have access to insurance and they don't have access to Medicaid, sometimes they delay prenatal care, we don't catch complications early enough, and it puts the baby and the mother's lives at risk," Klingler, who works in a small mountain town in central Idaho, told ABC News.

--
Meanwhile, Idaho has also turned a blind eye to maternal mortality rates.

essentialsaltes said:
Shooting the Messenger: Maternal Mortality Boards Under Threat in Some States with Abortion Restrictions

From the "Cases Will Go Down If We Stop Testing" files: The first shoe to drop was in Idaho in 2023, where the state agency that investigates deaths of pregnant women was simply eliminated, despite running at no cost to the state. This came amid a backdrop that includes not just the state's...

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Desk trauma · Wednesday at 7:59 PM

As I said before, I’m sure all the pro life medical staff that so many hands were rung over being compelled to be involved in abortions will flood the Idaho shortly. Wagons must have got stuck on I-80 but they’re coming!

CRAZY_CAT_WOMAN · Wednesday at 8:36 PM

This is what Trump supporters voted for. I'm just hoping this loss doesn't happen in California . At least the rich have access to all medical assistance. And the rich is what matters to Trump. Not his supporters and the poor.

Yttrium · Wednesday at 9:12 PM

Working as intended. As long as the number of abortions prevented is greater than the number of maternal deaths, then it's a net win for Idaho, right? Those OB-GYNs are a threat to the unborn. They should just shoo the rest of them all off to Washington and Oregon.

Nithavela · Thursday at 4:11 AM

As long as the lack of medical workers kills less people than they would have aborted, it's a net positive. Any caused suffering is a free bonus.

ozso · Thursday at 6:13 AM

Shutting down Auschwitz caused a lot of problems too.

NxNW · Thursday at 8:20 AM

ozso said:
Shutting down Auschwitz caused a lot of problems too.

You're saying doctors are nazis?

Desk trauma · Thursday at 8:27 AM

ozso said:
Shutting down Auschwitz caused a lot of problems too.

Godwin, right on time.

ThatRobGuy · Thursday at 8:55 AM

There is some pieces of info the ABC article is neglecting to mention...

There's a practical viewpoint, and philosophical viewpoint that can be discussed...

We'll start with the practical one:
The reason why this trend exists in Idaho is due to the fact that they have no mechanism to backfill attrition. (as they're a state that doesn't have an OBG-YN residency program - which makes recruiting new people a challenge)

I think there may be some definitional misalignments at play here as well.

Per this report (that covers the year prior to the ban)

https://familymedicine.uw.edu/chws/wp-content/uploads/sites/5/2022/08/Idaho_Physicians_FR_July_2022.pdf

There were 178 actively practicing in the state

Yet, the article is reporting that post-ban, the count went from 268 (in 2022) down to 174.

To the philosophical question - should people in important, key public-facing service positions (doctors, fireman, police, teachers) be able to dictate state policies by threatening to take their ball and go home (or to another state)?

If we just take the JAMA numbers at face value and go with "35% of the OBGYN's left the state due to the state's abortion laws"

When the voters in places like NYC, Seattle, and Portland voted for certain police reform laws and that will of the voters became codified into policy, and unusually high attrition (Seattle PD lost a quarter of their police) followed, should that be evidence of a policy's failure and need to revert it? I remember the tone of the articles covering those police attrition stories being quite different.

DaisyDay · Thursday at 9:22 AM

ThatRobGuy said:
There is some pieces of info the ABC article is neglecting to mention...

There's a practical viewpoint, and philosophical viewpoint that can be discussed...

We'll start with the practical one:
The reason why this trend exists in Idaho is due to the fact that they have no mechanism to backfill attrition. (as they're a state that doesn't have an OBG-YN residency program - which makes recruiting new people a challenge)

I think there may be some definitional misalignments at play here as well.

Per this report (that covers the year prior to the ban)

https://familymedicine.uw.edu/chws/wp-content/uploads/sites/5/2022/08/Idaho_Physicians_FR_July_2022.pdf
View attachment 368896

There were 178 actively practicing in the state

Yet, the article is reporting that post-ban, the count went from 268 (in 2022) down to 174.

Your chart only includes ob-gyns who are surgeons in 2021. Not all are.

ThatRobGuy said:
To the philosophical question - should people in important, key public-facing service positions (doctors, fireman, police, teachers) be able to dictate state policies by threatening to take their ball and go home (or to another state)?

They are not dictating state policies, as the onerous policies still exist, but people are allowed to change residence or workplace as they please. How is this even a question?

ThatRobGuy said:
If we just take the JAMA numbers at face value and go with "35% of the OBGYN's left the state due to the state's abortion laws"

When the voters in places like NYC, Seattle, and Portland voted for certain police reform laws and that will of the voters became codified into policy, and unusually high attrition (Seattle PD lost a quarter of their police) followed, should that be evidence of a policy's failure and need to revert it? I remember the tone of the articles covering those police attrition stories being quite different.

Oh what about something different that has nothing to do with the actual thread topic? Both sides attempted; both sides failed.

ThatRobGuy · Thursday at 9:42 AM

DaisyDay said:
Your chart only includes ob-gyns who are surgeons in 2021. Not all are.

They are not dictating state policies, as the onerous policies still exist, but people are allowed to change residence or workplace as they please. How is this even a question?

Oh what about something different that has nothing to do with the actual thread topic? Both sides attempted; both sides failed.

How so?

They're parallel types of incidents

The point/tone of the article is being presented as a cautionary tale of sorts -- that being "if you implement these restrictions against abortions, a bunch of your OBGYN's will leave your state", and presenting it with that tone is most certainly for the purposes of trying to influence policy.

When policies are implemented that causes a substantial portions of people in key public facing positions (doctors, teachers, police, fireman) to leave, should that be the metric used to determine whether or the policy was good or bad idea, or should it be based on it's own merits?

When I mentioned the tone of the articles were different in other very similar cases, that was an accurate statement.

Doctors are important
Police are important

Idaho abortion policies caused Doctors to leave
Seattle and NYC policing reform policies caused Police to leave/quit
(and in similar percentages)

Did ABC/CBS/NBC malign the policies in the case of the latter and present in a tone of "and this is why states should think twice before passing XYZ"? Or was the coverage more of an accusatory tone toward the people who were leaving?

And goes into the more overarching discussion of whether or not it's an acceptable arrangement to concede to people in key positions that have outsized leverage if they say "Because you need me and I provide a mission critical service, either I get outsized influence in the decision/discussion or I'm leaving, so you better think twice before voting against what I want"

Richard T · Thursday at 6:31 PM

ThatRobGuy said:
There is some pieces of info the ABC article is neglecting to mention...

There's a practical viewpoint, and philosophical viewpoint that can be discussed...

We'll start with the practical one:
The reason why this trend exists in Idaho is due to the fact that they have no mechanism to backfill attrition. (as they're a state that doesn't have an OBG-YN residency program - which makes recruiting new people a challenge)

I think there may be some definitional misalignments at play here as well.

Per this report (that covers the year prior to the ban)

https://familymedicine.uw.edu/chws/wp-content/uploads/sites/5/2022/08/Idaho_Physicians_FR_July_2022.pdf
View attachment 368896

There were 178 actively practicing in the state

Yet, the article is reporting that post-ban, the count went from 268 (in 2022) down to 174.

To the philosophical question - should people in important, key public-facing service positions (doctors, fireman, police, teachers) be able to dictate state policies by threatening to take their ball and go home (or to another state)?

If we just take the JAMA numbers at face value and go with "35% of the OBGYN's left the state due to the state's abortion laws"

When the voters in places like NYC, Seattle, and Portland voted for certain police reform laws and that will of the voters became codified into policy, and unusually high attrition (Seattle PD lost a quarter of their police) followed, should that be evidence of a policy's failure and need to revert it? I remember the tone of the articles covering those police attrition stories being quite different.

In addition to attrition, Idaho ranks dead last in the number of Dr's per per person for all 50 states. States ranked by total primary care physicians in 2024 | Becker's

BCP1928 · Thursday at 7:14 PM

ThatRobGuy said:
How so?

They're parallel types of incidents

The point/tone of the article is being presented as a cautionary tale of sorts -- that being "if you implement these restrictions against abortions, a bunch of your OBGYN's will leave your state", and presenting it with that tone is most certainly for the purposes of trying to influence policy.

When policies are implemented that causes a substantial portions of people in key public facing positions (doctors, teachers, police, fireman) to leave, should that be the metric used to determine whether or the policy was good or bad idea, or should it be based on it's own merits?

When I mentioned the tone of the articles were different in other very similar cases, that was an accurate statement.

Doctors are important
Police are important

Idaho abortion policies caused Doctors to leave
Seattle and NYC policing reform policies caused Police to leave/quit
(and in similar percentages)

Did ABC/CBS/NBC malign the policies in the case of the latter and present in a tone of "and this is why states should think twice before passing XYZ"? Or was the coverage more of an accusatory tone toward the people who were leaving?

And goes into the more overarching discussion of whether or not it's an acceptable arrangement to concede to people in key positions that have outsized leverage if they say "Because you need me and I provide a mission critical service, either I get outsized influence in the decision/discussion or I'm leaving, so you better think twice before voting against what I want"

Doctors are private citizens, free to work wherever they want. If badly written abortion laws put them into legal limbo, what should they do? Are not all private citizens free to leave a job if the working conditions don't suit them?

ThatRobGuy · Friday at 8:29 AM

BCP1928 said:
Doctors are private citizens, free to work wherever they want. If badly written abortion laws put them into legal limbo, what should they do? Are not all private citizens free to leave a job if the working conditions don't suit them?

They can absolutely leave if they want
(the same is actually true of the fireman, police, and teachers...they're not locked in like military members)

But as I noted, the tone is very different from coverage of previous incidents.

It was portrayed as "officers abdicating their responsibilities" and "officers being selfish and unwilling to work under the conditions/provisions that the citizens of the city wanted" when a quarter of the Seattle PD packed up and moved.

But nevertheless, it still comes down the question of whether or that sort of influence imbalance is a reasonable arrangement.

70% of a State's 2 million citizens want X
200 people in this mission critical area want Y

Admittedly, I can't think of a quick/easy solution to solve that imbalance short of some regulatory measures that would be more heavy handed than either faction would like.

ThatRobGuy · Friday at 8:43 AM

Richard T said:
In addition to attrition, Idaho ranks dead last in the number of Dr's per per person for all 50 states. States ranked by total primary care physicians in 2024 | Becker's

Idaho's had some challenges in that regard since 2012 from what I've been reading.

in the OBGYN field, that's even more pronounced due to the fact that they don't have any residencies for that specialty in the state (which can obviously make it difficult to backfill attrition)

While I'm not a pro-life person (in the conventional sense), if I were in charge of policy implementation for this sort of thing, there's some ducks I would've gotten in a row first before having the law take effect.

There are pro-life doctors out there, and pro-life med students that could backfill empty positions, but you need to have a way to get them there.... and in the medical field, that's not going to happen with no residency programs, and the 3rd lowest physician pay in the nation.

When Seattle had their police exodus, they were able to counter the exodus six months later via signing bonuses and retention bonus programs
"If you come be a cop here, we'll pay you $15k bonuses when you start, and if you stay a full 2 years, you'll get another $15k", and that seemed to be enough to replenish their ranks within a year.

It seems like Idaho should've had some similar things in mind.

Obviously for specialist physicians, you'd likely need to dangle a bigger carrot than 15k because it's a higher paying position.

But, just spitballing here... given that we're talking about only needing a few dozen people to backfill vacant OBGYN positions

A program to the effect of the state of Idaho allocating $5 million in their states' budget should be more than enough to offer a fairly generous partial tuition reimbursement program for it.

"For sixty physicians, if you come practice here, and stay for 2 years, we'll cover up to $60k of your outstanding student loans"

DaisyDay · Friday at 12:17 PM

My husband's cousin is a doctor. A rural town in Alabama sponsored him to come be their doctor. It's worked well so far.

One problem with ob-gyn practice in Idaho, is that best practices cannot be followed because of the law. This is discouraging to new practitioners who know their patients may need abortion services to save their lives. It's not just that it would be legally risky, but they won't have the actual knowledge and experience necessary.

Tropical Wilds · Friday at 12:29 PM

essentialsaltes said:
Dozens of OB-GYNs fled Idaho after its abortion ban. Medicaid cuts could make access to care even worse.
The state has lost over a third of its OB-GYNs -- 94 of 268 -- since the ban was enacted in 2022, according to a new study in medical journal JAMA Network Open.

[A year ago, they had 'only' lost 22% of them.]

After Bonner General closed its obstetric services, Kootenai Health, located an hour south, inherited its patients, which included residents across the northern tip of the state. Some women now have to drive two to three hours to get prenatal care or to deliver at Kootenai, according to one of its OB-GYNs, Dr. Brenna McCrummen.

"There have been patients that have delivered on the side of the road because they're not able to get to the hospital in time. There have been babies that have gone to the NICU who didn't do as well as they probably would have had they not had to travel long distances," she told ABC News.

More than 350,000 of the state's residents are insured by Medicaid, including those covered by the expansion plan voters approved through a ballot measure in 2018.

Under the federal changes, the state could lose $3 billion in funding over the next decade and 37,000 residents could lose coverage, according to analysis by KFF.

In Idaho, Medicaid covers around a third of births, according to data from March of Dimes.

"The worry is that as these changes are happening in the Medicaid space, it's going to be harder, particularly for rural hospitals, to maintain those obstetric services, and if they discontinue those, we've got more maternity care deserts, and we've got a greater risk of both moms and babies having worse outcomes," Warren said.

"If patients don't have access to insurance and they don't have access to Medicaid, sometimes they delay prenatal care, we don't catch complications early enough, and it puts the baby and the mother's lives at risk," Klingler, who works in a small mountain town in central Idaho, told ABC News.

--
Meanwhile, Idaho has also turned a blind eye to maternal mortality rates.

I lost my gyn to this. He packed up his tent and went to work at PP in MA. It was devastating because he is the best gyn I’d ever had… Though how he YOLOed through the last months at the hospital was dazzling to see and warmed my heart. He wore ALL the pins. Pronouns, trans support, women’s access… It was glorious.

Our local PP simply shifted to VT and it was no big deal.

How women in larger states that don’t border more rational states deal with this, I can only imagine.

Desk trauma · Friday at 12:50 PM

Tropical Wilds said:
How women in larger states that don’t border more rational states deal with this, I can only imagine.

Just wait for the fugitive ~~slave~~ woman laws.

RileyG · 2025-08-23T01:42:28-0500

essentialsaltes said:
Dozens of OB-GYNs fled Idaho after its abortion ban. Medicaid cuts could make access to care even worse.
The state has lost over a third of its OB-GYNs -- 94 of 268 -- since the ban was enacted in 2022, according to a new study in medical journal JAMA Network Open.

[A year ago, they had 'only' lost 22% of them.]

After Bonner General closed its obstetric services, Kootenai Health, located an hour south, inherited its patients, which included residents across the northern tip of the state. Some women now have to drive two to three hours to get prenatal care or to deliver at Kootenai, according to one of its OB-GYNs, Dr. Brenna McCrummen.

"There have been patients that have delivered on the side of the road because they're not able to get to the hospital in time. There have been babies that have gone to the NICU who didn't do as well as they probably would have had they not had to travel long distances," she told ABC News.

More than 350,000 of the state's residents are insured by Medicaid, including those covered by the expansion plan voters approved through a ballot measure in 2018.

Under the federal changes, the state could lose $3 billion in funding over the next decade and 37,000 residents could lose coverage, according to analysis by KFF.

In Idaho, Medicaid covers around a third of births, according to data from March of Dimes.

"The worry is that as these changes are happening in the Medicaid space, it's going to be harder, particularly for rural hospitals, to maintain those obstetric services, and if they discontinue those, we've got more maternity care deserts, and we've got a greater risk of both moms and babies having worse outcomes," Warren said.

"If patients don't have access to insurance and they don't have access to Medicaid, sometimes they delay prenatal care, we don't catch complications early enough, and it puts the baby and the mother's lives at risk," Klingler, who works in a small mountain town in central Idaho, told ABC News.

--
Meanwhile, Idaho has also turned a blind eye to maternal mortality rates.

Ban this draconian practice everywhere! Protect women, the unborn, and the most vulnerable!

Do the right thing!

RileyG · 2025-08-23T01:43:12-0500

NxNW said:
You're saying doctors are nazis?

No. I think he is comparing the abortion # of deaths to the holocaust.

Dozens of OB-GYNs fled Idaho after its abortion ban. Medicaid cuts could make access to care even worse.

Fact-Based Lifeform