Pediatric ICUs are closing across the U.S., leaving critically ill kids with fewer options

America's pediatric ICUs are quietly disappearing. Over the past year, hospitals in Montana, Oregon, Missouri, Illinois, and California have closed units dedicated to critically ill children, consolidating care into large regional medical hubs. That means families in rural and suburban areas may now face hours-long drives or emergency flights to reach the nearest pediatric critical care bed — a reality that doctors warn could cost lives.

The closures are driven by a perfect storm of low patient volumes, a national shortage of pediatric subspecialists (who earn less than their adult-focused peers), and hospitals being reimbursed less for treating children than adults. Experts also flag that as pediatric care centralizes, even routine procedures like appendectomies are disappearing from community hospitals — down more than 50% from 2003 to 2022.

By the Numbers:

• Pediatric inpatient units dropped ~30% from 2008 to 2022 (1,749 → 1,226 hospitals)
• ~75% of hospitals now lack any pediatric inpatient services
• ~50% of U.S. children are covered by Medicaid or CHIP
• Hospitals performing pediatric appendectomies fell >50% from 2003 to 2022

Why it matters: Proposed Medicaid cuts could deepen the financial strain on hospitals that still serve kids, accelerating closures and widening care gaps — particularly in rural communities where alternatives are already scarce.