Unlike FM-HD transmission equipment, AM HD exciters, importers, etc. are not really available to purchase anymore. Most if the original AM-HD gear is based on a PC, including software and custom made one-off hardware. For stations that are still broadcasting AM-HD, they purchased enough spare gear to keep it running. Once that transmission gear dies, stations go back to analog only due to lack of manufacturer support.
Another barrier for AM stations, is their antenna system. Some of the older antenna and phasing equipment can't provide enough bandwidth to support the digital sidebands. In many cases, broad-banding directional AM transmission antenna systems either can't be done due to the limits of physics, or would be cost prohibitive.