Congress tests new maternity payment models to close racial health gaps
H.R. 8907 — IMPACT to Save Moms Act · Filed by Jan Schakowsky (D-IL) · 72 cosponsors · Introduced May 19, 2026 · Referred to committee
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What it does
This bill directs the Centers for Medicare & Medicaid Services to run a five-year demonstration project (2027–2031) allowing states to test new payment models for maternity care under Medicaid and the Children's Health Insurance Program. The project will test whether alternative payment approaches—including risk-adjusted payments, diverse care teams (midwives, doulas, mental health providers), and attention to social determinants of health—can improve maternal health outcomes, particularly for racial and ethnic minorities and other groups with elevated maternal mortality and morbidity. States apply voluntarily; CMS evaluates outcomes and reports to Congress on whether to expand the model nationally.
Why we flagged it
The bill's operative mechanism is a time-limited, voluntary state-level demonstration project designed to test payment innovations for maternal care. It is fundamentally a research and evaluation vehicle, not a permanent entitlement or regulatory mandate, with explicit equity focus and congressional reporting requirements.
What the text implies
- The bill's definition of 'maternal mortality' explicitly includes deaths from suicide, overdose, and mental health/substance use disorders 'attributed to or aggravated by' pregnancy—a broader definition than CDC standard, potentially increasing measured maternal mortality rates and justifying expanded mental health and addiction services in maternity payment models.
- By requiring 'diverse maternity care teams' including doulas, community health workers, and perinatal health workers, the bill may shift reimbursement patterns away from physician-centric models toward team-based care, potentially affecting physician billing and creating new reimbursement categories for non-clinical workers.
The full analysis lists 4 implications of this text.
Who stands to gain
Medicaid managed care organizations (if states contract with MCOs to implement alternative payment m; Midwifery practices and freestanding birth centers (expanded reimbursement pathways); Community health worker organizations and doula networks (new or expanded reimbursement categories)