In rural areas, mothers with private health insurance sometimes drive past the closest hospital to have their baby. This means the nearby place has fewer births, which can hurt its money situation. Private insurance pays more than government help, so when moms skip out, the local hospital loses important cash. This bypass behavior can make it hard for small hospitals to stay open and keep their baby delivery services.
Between 2016 and 2021, about half of these rural moms with private insurance didn't go to the nearest hospital. They were more likely to skip if the close hospital was in a non-rural area, had few babies born there, or didn't have special care for newborns. Also, if there was another hospital nearby or if the mom's pregnancy was riskier, they tended to go farther. These choi