SEC. 2. STATE OPTION UNDER MEDICAID PROGRAM TO 
PROVIDE FOR AND EXTEND CONTINUOUS 
COVERAGE FOR CERTAIN INDIVIDUALS. 
(a) STATE OPTION TO EXTEND CONTINUOUS COV-
ERAGE
FOR
PREGNANT
AND
POSTPARTUM
INDIVID-
UALS.—Title XIX of the Social Security Act (42 U.S.C. 
1396 et seq.) is amended— 
(1) in section 1902(e)(5), by inserting after 
‘‘60-day period’’ the following: ‘‘or, at the option of 
the State, 1-year period’’; 
(2) in section 1902(e)(6), by inserting after 
‘‘60-day period’’ the following: ‘‘or, at the option of 
the State, 1-year period’’; 
(3) in section 1902(l)(1)(A), by inserting after 
‘‘60-day period’’ the following: ‘‘, or, at the option 
of the State, 1-year period,’’; 
(4) in section 1903(v)(4)(A)(i), by inserting 
after ‘‘60-day period’’ the following: ‘‘, or, at the op-
tion of the State, 1-year period,’’; and 
(5) in section 1905(a), in the fourth sentence in 
the matter following paragraph (30), by inserting 
after ‘‘60-day period’’ the following: ‘‘, or, at the op-
tion of the State, 1-year period,’’. 
(b) STATE OPTION TO PROVIDE CONTINUOUS COV-
ERAGE FOR FULL BENEFITS FOR INDIVIDUALS WHO ARE 
OR BECOME PREGNANT.—Section 1902(e)(6) of the So-
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cial Security Act (42 U.S.C. 1396a(e)(6)), as amended by 
subsection (a), is further amended— 
(1) by striking ‘‘(6) In the case of a pregnant 
woman’’ and inserting 
‘‘(6)(A) In the case of a pregnant woman’’; and 
(2) by adding at the end the following: 
‘‘(B)(i) At the option of the State, the State plan may 
provide that an individual who is eligible for medical as-
sistance under the State plan (or a waiver of such plan) 
or for child health assistance under title XXI and who is, 
or who while so eligible becomes, pregnant shall continue 
to be eligible for such medical assistance or child health 
assistance, respectively, through the end of the month in 
which the 1-year period (beginning on the last day of such 
pregnancy) ends, regardless of the basis for the individ-
ual’s eligibility for such medical assistance.’’. 
(c) INCREASE OF FMAP.—Section 1905 is amended 
by adding at the end the following new subsection: 
‘‘(gg) 
TEMPORARY
INCREASE
FOR
CERTAIN 
STATES.—Notwithstanding subsection (b) or (z)(2), in the 
case of a State that makes an election under section 
1902(e)(6)(B) to provide for continuation described in 
such section, the Federal medical assistance percentage 
for such State shall be increased by 5 percentage points 
with respect to medical assistance furnished during such 
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quarter. The previous sentence shall apply only with re-
spect to calendar quarters occurring during 2020.’’. 
(d) APPLICATION TO CHIP OPTIONAL COVERAGE OF 
TARGETED LOW-INCOME PREGNANT WOMEN.—Section 
2112 of the Social Security Act (42 U.S.C. 1397ll) is 
amended— 
(1) in subsection (d)(2)(A), by inserting after 
‘‘60-day period’’ the following: ‘‘, or, at the option 
of the State, 1-year period’’; and 
(2) in subsection (f)(2), by inserting after ‘‘60- 
day period’’ the following: ‘‘, or, at the option of the 
State, 1-year period’’. 
(e) EFFECTIVE DATE.—The amendments made by 
this section shall apply with respect to eligibility deter-
minations for items and services under State plans under 
title XIX of the Social Security Act (or a waiver of such 
a plan) (42 U.S.C. 1396 et seq.) and under State child 
health plans under title XXI (or waiver of such a plan) 
made on or after January 1, 2020. 
SEC. 3. MACPAC REPORT. 
(a) IN GENERAL.—Not later than 1 year after the 
date of the enactment of this Act, the Medicaid and CHIP 
Payment and Access Commission (referred to in this sec-
tion as ‘‘MACPAC’’) shall publish a report on the coverage 
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of doula care under State Medicaid programs, which shall 
at a minimum include the following: 
(1) Information about coverage for doula care 
under State Medicaid programs that currently pro-
vide coverage for such care, including the type of 
doula care offered (such as prenatal, labor and deliv-
ery, postpartum support, and also community-based 
and traditional doula care). 
(2) An analysis of barriers to covering doula 
care under State Medicaid programs. 
(3) An identification of effective strategies to 
increase the use of doula care in order to provide 
better care and achieve better maternal and infant 
health outcomes, including strategies that States 
may use to recruit, train, and certify a diverse doula 
workforce, particularly from underserved commu-
nities, communities of color, and communities facing 
linguistic or cultural barriers. 
(4) Recommendations for legislative and admin-
istrative actions to increase access to doula care in 
State Medicaid programs, including actions that en-
sure doulas may earn a living wage that accounts for 
their time and costs associated with providing care. 
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(b) STAKEHOLDER CONSULTATION.—In developing 
the report required under subsection (a), MACPAC shall 
consult with relevant stakeholders, including— 
(1) States; 
(2) organizations representing consumers, in-
cluding those that are disproportionately impacted 
by poor maternal health outcomes; 
(3) organizations and individuals representing 
doula care providers, including community-based 
doula programs and those who serve underserved 
communities, including communities of color, and 
communities facing linguistic or cultural barriers; 
and 
(4) organizations representing health care pro-
viders. 
Æ 
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