H.R. 9712: Mamas First Act

This bill would change Medicaid rules so that, starting January 1, 2027, states must cover certain pregnancy- and postpartum-related services provided by:

• doulas,
• midwives,
• tribal midwives, and
• lactation support providers.

The covered services would include prenatal care, labor and delivery support, and postpartum care. The bill says these services could be provided in a home, community setting, hospital, birth center, clinic, or health unit, and could also be provided through telehealth if state law allows it.

It defines who can qualify as each type of provider for Medicaid purposes. For example, a doula would generally need to be certified by an organization that requires continuing education, have certain references from clients or licensed health professionals, and be authorized by the state Medicaid program. A midwife or tribal midwife would need to be authorized by the state Medicaid program, or in some cases meet international midwifery standards or be recognized by an Indian tribe. A lactation support provider would need to be authorized by the state Medicaid program and meet certain training or recognition standards.

The bill would also prohibit Medicaid from charging cost-sharing, such as copays, for these services. In other words, eligible Medicaid enrollees would not have to pay extra out of pocket for covered doula, midwife, tribal midwife, or lactation support services.

States would have to update their Medicaid plans to comply. If a state needs to pass its own legislation to do so, the bill gives that state extra time before it is treated as out of compliance.

The bill includes findings saying that maternal mortality is a serious problem in the United States, that rates differ across racial and ethnic groups, and that doula and midwifery care are associated with better outcomes and lower costs. These findings explain the bill’s purpose but do not themselves create new rules.

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