Medicaid now covers doulas and midwives to cut maternal deaths

What it does

This bill requires state Medicaid programs to cover services provided by doulas, midwives, tribal midwives, and lactation support providers starting January 1, 2027. It defines eligibility for each provider type (doulas must be certified and have client references; midwives must meet state authorization or international standards; lactation providers must complete WHO/UNICEF training or equivalent), mandates that states include these services in their Medicaid plans, and prohibits cost-sharing (copays, coinsurance, deductibles) for these services. The bill is framed around evidence that these services reduce maternal mortality and improve birth outcomes, particularly for Black and Indigenous women who face the highest maternal death rates.

Why we flagged it

The bill's core mechanism is straightforward: it mandates Medicaid coverage of three categories of maternal health providers and prohibits cost-sharing. The legislative findings establish a public health rationale (reducing preventable maternal deaths, addressing racial disparities), and the operative sections directly implement that purpose without hidden riders or misdirection.

What the text implies

• States must absorb the cost of expanded Medicaid coverage for these services; the bill does not appropriate federal funds to offset state spending, potentially creating budget pressure on state Medicaid programs.
• The bill allows states to define doulas, midwives, and lactation providers through their own plan amendments or waivers, creating potential variation in coverage scope and provider eligibility across states.

The full analysis lists 4 implications of this text.

Who stands to gain

doulas (independent practitioners); midwives (independent practitioners and birth centers); lactation consultants and support providers