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May 6, 2021

Pressley, Booker, Colleagues Reintroduce MOMMIES Act to Promote Community-Based, Holistic Maternal Health Care

Bill Text (PDF) | One-Pager (PDF)

WASHINGTON – Congresswoman Ayanna Pressley (MA-07) and Senator Cory Booker (D-NJ) today introduced the MOMMIES (Maximizing Outcomes for Moms through Medicaid Improvement and Enhancement of Service) Act to expand coverage for pregnant people through Medicaid, which covers nearly half of all births in the United States.

The bill extends coverage for birthing people from two months to a full year after childbirth, increasing access to primary care and reproductive health providers and ensuring that all pregnant and postpartum people have full Medicaid coverage, rather than coverage that can be limited to arbitrarily picked pregnancy-related services.

The MOMMIES Act focuses on improving maternal health outcomes, reversing the trend of rising maternal mortality rates and closing persistent disparities that put Black, Indigenous, and People of Color (BIPOC) communities at greater risk of complications. It builds on the recent expansion of Medicaid coverage for pregnant postpartum people that the lawmakers helped secure through the American Rescue Plan.

The bill is co-sponsored by Representatives Cori Bush (MO-01), Eleanor Holmes Norton (D-DC), Steve Cohen (TN-09), Sheila Jackson Lee (TX-18), Lucille Roybal-Allard (CA-40), Rashida Tlaib (MI-13), Peter Welch (D-VT), Mondaire Jones (NY-17), Henry C. “Hank” Johnson, Jr. (GA-04), Lauren Underwood (IL-14), Robin L. Kelly (IL-02), Doris Matsui (CA-06), Veronica Escobar (TX-16), André Carson (IN-07), Bill Foster (IL-11), and Senators Kirsten Gillibrand (D-NY), Tammy Baldwin (D-WI), Richard Blumenthal (D-CT), Elizabeth Warren (D-MA), and Mazie Hirono (D-HI).

Rep. Pressley will discuss the legislation and her ongoing work on Black maternal health during an House Oversight Committee hearing today.

“A safe and healthy pregnancy should be a fundamental human right, but far too many people in America —particularly Black women—still find themselves without the high-quality, comprehensive care they need for themselves and their babies,” said Congresswoman Pressley. “Our bill would help change that by promoting community-based, holistic approaches to maternity and post-partum care so that every pregnant person is treated with the dignity and respect they deserve during and after childbirth. Our fight for maternal justice continues.”

“We live in a nation that spends more than any other country on health care, yet we still have the highest rate of pregnancy-related deaths of any of our peer countries,” said Senator Booker. “And Black women are more than three times as likely to die from complications related to pregnancy than white women — in New Jersey they are five times as likely. New Jersey also has the unfortunate distinction of having the fifth-highest rate of maternal mortality in the U.S. We simply cannot continue to accept this alarming status quo — we must do something about it and this bill is an important first step. By expanding Medicaid coverage for pregnant people, we can begin to stem the rising tide of maternal mortality and close the egregious racial gaps that exist in maternal and infant health outcomes.”

Between 2000 and 2014, the maternal mortality rate in the U.S. increased by 26 percent, while it decreased in nearly every other country. And stark disparities in maternal deaths exist, as Black women are more than three times as likely to die from pregnancy-related causes as white women. Additionally, for every person who dies due to a pregnancy-related complication, dozens more suffer from unexpected outcomes from pregnancy that result in both short- and long-term consequences to a person’s health.

Specifically, the MOMMIES Act would:

  • Extend Medicaid coverage for postpartum people to a full year after giving birth, rather than the current limit of 60 days that many face; 
  • Ensure that all pregnant and postpartum people have full Medicaid coverage, rather than coverage that can be limited to arbitrarily picked pregnancy-related services. This is particularly critical for reducing disparities, as benefits for pregnant people covered by Medicaid vary depending on their eligibility group and what state they’re located in; 
  • Establish a Maternity Care Home demonstration project to study the effectiveness of this innovative model of maternity care. Maternity Care Homes show great promise in improving maternal health outcomes, as they are based on a model of care that is patient-centered, coordinated, and comprehensive. Maternity Care Homes have also shown early successes in reducing health care costs, increasing the number of prenatal visits, and reducing the number of low birthweight infants. Data from the pilot programs can be used to implement the model on a wider scale; 
  • Extend the Affordable Care Act’s primary care bump to ensure that Medicaid beneficiaries have access to primary care providers, including reproductive health providers; 
  • Facilitate increased access to doula support. Doulas are support personnel who provide pregnant people with emotional, physical, and informational support. Doula support has been shown to improve maternal and infant health outcomes, particularly among people of color, but currently, only a handful of states have authorized Medicaid coverage for doulas. The MOMMIES Act would facilitate increased access to doula support by requiring the Medicaid and CHIP Payment and Access Commission (MACPAC) to publish a report on coverage of doula support under Medicaid, including recommendations for legislative and administrative actions to increase access to such support.  
  • Study telehealth and its potential to improve Medicaid beneficiaries’ access to maternity care. Telehealth programs show promise in increasing access to maternity care, particularly in rural and other underserved areas. To learn about telehealth’s potential to increase access to maternity care, the MOMMIES Act would require a Government Accountability Office report on states that are currently providing this coverage and recommendations for increasing access to telehealth for pregnant people.

The MOMMIES Act is endorsed by the following organizations: Ancient Song Doula Services; Association of Maternal & Child Health Programs; Black Mamas Matter Alliance; Black Women’s Health Imperative; Center for Reproductive Rights; Children’s Dental Health Project; Every Mother Counts; In Our Own Voice; March of Dimes; Moms Rising; National Asian Pacific American Women’s Forum; National Health Law Program; National Latina Institute for Reproductive Health; National Partnership for Women & Families; and the National Women’s Law Center 1000 Days.

“The National Birth Equity Collaborative enthusiastically supports the reintroduction of the MOMMIES Act and the Healthy MOMMIES Act! We applaud its legislative aims to enhance Medicaid benefits for low-income pregnant people by requiring uninterrupted coverage for the full length of the postpartum period, which spans one-year. We are thrilled that birth equity is a goal of the Demonstration Project and, even more, that trainings through an anti-racist lens will also be one of the required functions. Unequivocally, the inclusion of the reproductive justice framework into provider training is what sets these bills apart, marking them both transformational and timeless.” –Dr. Joia Crear Perry, Founder and President of the National Birth Equity Collaborative

“Every Mother Counts applauds Sen. Booker and Rep. Pressley for taking bold action to advance quality, respectful, and equitable maternity care through the MOMMIES Act. This past year has magnified the critical need to support those most at risk of poor maternal health outcomes and disparities. We know the value of community-based doula support, maternity care homes, telehealth options, and the continuity of care from extended postpartum Medicaid coverage. The MOMMIES Act would provide the support and solutions needed to eliminate devastating racial disparities and move our country towards birth justice and equity.”– Christy Turlington Burns, Founder of Every Mother Counts

“We need the Healthy MOMMIES Act now more than ever,” said Jennifer Jacoby, Senior Federal Policy Counsel at the Center for Reproductive Rights. “This past year in particular has highlighted the devastating inequities present in our health care system, with Black and Brown families and those struggling to make ends meet disproportionately impacted by the COVID-19 pandemic. Those same communities are experiencing a crisis in maternal health, with Black and Indigenous birthing people suffering alarming rates of pregnancy-related complications and death. The MOMMIES Act is an essential step in reducing those health disparities.”

“The National Health Law Program urges Congress to pass the MOMMIES Act, which would enhance Medicaid’s maternal health coverage and tackle urgent racial injustices in maternal health. By setting a national floor of comprehensive pregnancy-related coverage at a year postpartum, advancing access to doula services, and emphasizing health equity-, antiracist-, and community-based reforms, the MOMMIES Act takes vital steps toward ending our country’s Black and Indigenous maternal mortality epidemic.” —Elizabeth Taylor, Executive Director, National Health Law Program

The Healthy MOMMIES Act would make important enhancements to Medicaid and the Children’s Health Insurance Program (CHIP)–two vital publicly-funded health programs that disproportionately serve birthing people and families of color. Health care innovations such as extending postpartum coverage to one year, Medicaid coverage of community-based doula care, and increased access to telehealth will help get the U.S. on a path to truly realizing maternal health equity. Strengthening both health care access and coverage are essential, and must go hand in hand with efforts to transform how women of color are treated within the health care system. — Dr. Jamila Taylor, Director of Health Care Reform and Senior Fellow at The Century Foundation

“Access to comprehensive, high-quality health care services has proven to improve maternal health outcomes. Without health care coverage, many pregnant and birthing people – especially people with low incomes – may be forced to forgo necessary and preventive care including recommended post-partum visits, mental health treatment, family planning services and more. The Healthy Mommies Act would help address this inequity by expanding postpartum Medicaid coverage to at least one year, among other important health care advancements. At a time when the nation is addressing a public health pandemic and economic crisis, which has resulted in unprecedented job loss, and subsequently, the loss of job-based health insurance coverage for many, improving pregnant people’s access to Medicaid is critical. We applaud Representative Ayanna Pressley and Senator Cory Booker for leading on this effort, which would move our country closer towards achieving maternal health equity, particularly for Black and Indigenous people, who have been disproportionately harmed by COVID-19, and the maternal health and economic crises.” – Jamille Fields Allsbrook, JD/MPH, Director of Women’s Health and Rights at the Center for American Progress.

As a founding member of the Black Maternal Health Caucus, Congresswoman Pressley is committed to ending the Black maternal mortality crisis in America and affirming maternal health justice for all. In May 2019, she first introduced the  MOMMIES Act, to extend post-partum Medicaid coverage for pregnant people and expand coverage to include culturally competent and community based doula care. In February 2021, she re-introduced the Justice for Incarcerated Moms Act, legislation to improve maternal health care and support for pregnant individuals who are incarcerated. The legislation was initially filed in March 2020.

Last month, during Black Maternal Health Week, Rep. Pressley introduced the COVID-19 Safe Birthing Act, bold legislation to provide critical protections and access to care for pregnant people during the COVID-19 pandemic. In an op-ed published in The Root last month, Rep. Pressley and Dr. Myechia Minter-Jordan discussed the growing Black maternal health crisis and laid out a number of bold solutions to confront the crisis head-on.

In November, at a briefing held by the U.S. Commission on Civil Rights (USCCR), Congresswoman Pressley delivered testimony on the growing racial disparities in maternal health and the urgent need to combat the Black maternal mortality crisis. Her full testimony at the briefing is available here.


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