Mamas First Act

[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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