Mamas First Act

To amend title XIX of the Social Security Act to provide coverage under the Medicaid program for services provided by doulas and midwives, and for other purposes. 1. Short title This Act may be cited as the Mamas First Act 2. Findings Congress finds the following: (1) According to the Centers for Disease Control and Prevention, the maternal mortality rate varies drastically for women by race and ethnicity. On average, there are 12.7 deaths per 100,000 live births for White women, 43.5 deaths per 100,000 live births for African-American women, 32.5 deaths for American Indian and Alaskan Native women, and 14.4 deaths per 100,000 live births for women of other ethnicities. While maternal mortality disparately impacts African-American women and indigenous women, this urgent public health crisis traverses race, ethnicity, socioeconomic status, educational background, and geography. (2) United States maternal mortality rates are the highest in the developed world and are increasing rapidly. (3) Many of these maternal deaths are likely preventable. (4) According to the National Institutes of Health, doula-assisted mothers are four times less likely to have a low-birth-weight baby, two times less likely to experience a birth complication involving themselves or their baby, and significantly more likely to initiate breastfeeding. (5) Midwife-led care is associated with cost savings, decreased rates of intervention, lower cesarean rates, lower preterm birth rates, and healthier outcomes for mothers and babies. (6) Midwives may practice in any setting, including the home, community, hospitals, birth centers, clinics, or health units. 3. Medicaid coverage of services provided by doulas and midwives (a) In general Section 1905 of the Social Security Act ( 42 U.S.C. 1396d (1) in subsection (a)— (A) in paragraph (30), by striking and (B) by redesignating paragraph (31) as paragraph (32); and (C) by inserting after paragraph (30) the following new paragraph: (31) services and care, including prenatal, delivery, and postpartum care, that is provided in a culturally congruent manner (as defined in subsection (kk)) by doulas, midwives, and tribal midwives (as those terms are defined in subsection (jj)), that is provided in the home, community, a hospital, birth center, clinic, health unit, or is furnished via telehealth to the extent authorized under State law; and ; and (2) by adding at the end the following: (jj) Doulas, midwives, and tribal midwife defined For purposes of subsection (a)(31): (1) Doulas defined The term doula (A) has completed 60 hours of foundational training; (B) is certified by an organization, which has been established for not less than five years and which requires the completion of continuing education to maintain such certification, to provide non-medical advice, information, emotional support, and physical comfort to an individual during such individual’s pregnancy, childbirth, and postpartum period; and (C) maintains such certification by completing such required continuing education. (2) Midwives defined The term midwife (3) Tribal midwife defined The term tribal midwife 25 U.S.C. 1603 (kk) Culturally congruent care defined For purposes of subsection (a)(31), the term culturally congruent care . (b) Requiring mandatory coverage under State plan Section 1902(a)(10)(A) of the Social Security Act ( 42 U.S.C. 1396a(a)(10)(A) and (30) (30), and (31) (c) Conforming amendments (1) Section 1902(nn)(3) of the Social Security Act ( 42 U.S.C. 1396a(nn)(3) (30) (32) (2) Section 1905(a) of the Social Security Act ( 42 U.S.C. 1396d(a) (30) (32) (d) Effective date (1) In general Subject to paragraph (2), the amendments made by this section shall apply with respect to medical assistance furnished on or after January 1, 2022. (2) Exception for State legislation In the case of a State plan under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq.

Summary: Mamas First Act This bill requires state Medicaid programs to cover doula and midwife services, including prenatal, delivery, and postpartum services, in a variety of settings.