[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 9712 Introduced in House (IH)]
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119th CONGRESS
2d Session
H. R. 9712
To amend title XIX of the Social Security Act to provide coverage under
the Medicaid program for services provided by doulas, midwives, and
lactation support providers, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
July 15, 2026
Ms. Moore of Wisconsin (for herself, Mrs. Dingell, Ms. Pressley, Ms.
Adams, Ms. Underwood, Ms. Norton, Mr. Green of Texas, Mrs. Grijalva,
Mr. Lieu, and Ms. Schakowsky) introduced the following bill; which was
referred to the Committee on Energy and Commerce
_______________________________________________________________________
A BILL
To amend title XIX of the Social Security Act to provide coverage under
the Medicaid program for services provided by doulas, midwives, and
lactation support providers, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Mamas First Act''.
SEC. 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 13.6 deaths
per 100,000 live births for White women, 45 deaths per 100,000
live births for Black women, and 13.9 deaths per 100,000 live
births for Hispanic women. For American Indian and Alaskan
Native women, the National Council of Urban Indian Health
estimates there are 54.6 deaths per 100,000 live births. While
maternal mortality most disparately impacts Black 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
among similarly economically situated countries and continue to
increase.
(3) Four out of 5 of these maternal deaths are likely
preventable.
(4) According to the National Institutes of Health,
individuals who have doula support during their pregnancy are 4
times less likely to have a low-birth-weight baby, 2 times less
likely to experience a birth complication involving themselves
or their baby, and significantly more likely to initiate
breastfeeding.
(5) Midwifery-led care is associated with cost savings,
decreased rates of intervention, lower rates of cesarean birth,
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.
SEC. 3. MEDICAID COVERAGE OF SERVICES PROVIDED BY DOULAS, MIDWIVES, AND
LACTATION SUPPORT PROVIDERS.
(a) In General.--Section 1905 of the Social Security Act (42 U.S.C.
1396d) is amended--
(1) in subsection (a)--
(A) in paragraph (31), by striking ``and'' at the
end;
(B) by redesignating paragraph (32) as paragraph
(33); and
(C) by inserting after paragraph (31) the following
new paragraph:
``(32) services and care, including prenatal, labor, and
postpartum care, that is provided in a culturally congruent
manner by doulas, midwives, tribal midwives, and lactation
support providers (as those terms are defined in subsection
(ll)), that is provided in the home, community, a hospital,
birth center, clinic, or health unit, or is furnished via
telehealth to the extent authorized under State law; and''; and
(2) by adding at the end the following:
``(ll) Doulas, Midwives, Tribal Midwives, and Lactation Support
Providers Defined.--For purposes of subsection (a)(32):
``(1) Doula defined.--The term `doula' means an individual
who--
``(A)(i) is certified by an organization 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
``(ii) maintains such certification by completing
such required continuing education;
``(B) can provide a recommendation from at least--
``(i) three different former clients for
whom the prospective doula provided doula
services (either paid or volunteer) within the
last 5 years; or
``(ii) two different licensed health care
providers (including physicians, midwives,
social workers, or nurses) who observed the
prospective doula providing doula services
within the last 5 years; or
``(C) is authorized to serve as a Medicaid provider
of doula services under the State plan under this title
(or a waiver of such plan) of the individual's State.
``(2) Midwife defined.--The term `midwife' means a midwife
who--
``(A) is authorized to serve as a Medicaid provider
of midwife services under the State plan under this
title (or a waiver of such plan) of the individual's
State; or
``(B) meets at a minimum the international
definition of the midwife and global standards for
midwifery education as established by the International
Confederation of Midwives.
``(3) Tribal midwife defined.--The term `tribal midwife'
means an individual who--
``(A) is authorized to serve as a Medicaid provider
of tribal midwife services under the State plan under
this title (or a waiver of such plan) of the
individual's State; or
``(B) is recognized by an Indian tribe (as defined
in section 4 of the Indian Health Care Improvement Act
(25 U.S.C. 1603)) to practice midwifery for such tribe.
``(4) Lactation support provider defined.--The term
`lactation support provider' means an individual who--
``(A) is authorized to serve as a Medicaid provider
of lactation support services under the State plan
under this title (or a waiver of such plan) of the
individual's State;
``(B) has completed at least 20 hours of
foundational training based on the World Health
Organization/United Nations Children's Fund lactation
counseling training blueprint, or an equivalent
training; or
``(C) is recognized within any category on the
Lactation Support Provider Descriptor chart published
by the U.S. Breastfeeding Committee-affiliated
Lactation Support Provider Constellation.''.
(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))
is amended, in the matter preceding clause (i), by striking ``and
(30)'' and inserting ``(30), and (32)''.
(c) Cost Sharing Prohibition.--Title XIX of the Social Security Act
(42 U.S.C. 1396 et seq.) is amended--
(1) in subsections (a)(2)(B) and (b)(2)(B) of section 1916
(42 U.S.C. 1396o(a)(2)(B), (b)(2)(B)), by inserting after the
comma at the end ``and services and care (including prenatal,
labor, and postpartum care) provided by a doula, midwife,
tribal midwife, or lactation support provider (as those terms
are defined in section 1905(ll)),''; and
(2) in section 1916A(b)(3)(B)(iii) (42 U.S.C. 1396o-
1(b)(3)(B)(iii)), by inserting before the period at the end ``,
and services and care (including prenatal, labor, and
postpartum care) provided by a doula, midwife, tribal midwife,
or lactation support provider (as those terms are defined in
section 1905(ll))''.
(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, 2027.
(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.) that the Secretary of Health and Human
Services determines requires State legislation in order for the
respective plan to meet any requirement imposed by amendments
made by this section, the respective plan shall not be regarded
as failing to comply with the requirements of such title solely
on the basis of its failure to meet such an additional
requirement before the first day of the first calendar quarter
beginning after the close of the first regular session of the
State legislature that begins after the date of the enactment
of this Act. For purposes of the previous sentence, in the case
of a State that has a 2-year legislative session, each year of
the session shall be considered to be a separate regular
session of the State legislature.
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