Bill Expands and Enhances Coverage for Pregnant People Enrolled in Medicaid, Including Access to Community-Based Doula Care

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

WASHINGTON — Today Congresswoman Ayanna Pressley (MA-07) and Senator Cory Booker (D-NJ) reintroduced the Maximizing Outcomes for Moms through Medicaid Improvement and Enhancement of Services (MOMMIES) Act, legislation that would seek to improve maternal health outcomes, reverse the trend of rising maternal mortality rates, and close disparities that put Black, Indigenous, and People of Color (BIPOC) communities and their kids at greater risk.

The bill would expand coverage for pregnant people covered by Medicaid — which covers nearly half of all births in the U.S. — by extending postpartum coverage from two months to a full year after childbirth; ensuring that all pregnant and postpartum people have full Medicaid coverage, rather than coverage that can be limited to pregnancy-related services; and increasing access to primary care providers and reproductive health providers.

“My paternal grandmother died in the 1950s while giving birth, and it is absolutely damning that decades later, the Black maternal morbidity crisis in America is still killing our loved ones and destabilizing our families,” said Rep. Pressley. “With the Supreme Court’s cruel Dobbs decision only exacerbating this crisis, Congress must pass our bill to promote 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 their pregnancy. Maternal health justice is a racial justice issue and a matter of life and death, and we must make comprehensive, culturally-congruent reproductive care a reality for all.”

“The United States spends more on health care than any other nation, but we still have the highest rate of maternal mortality among our peer countries,” said Senator Booker. “We must ensure that no person, regardless of their background, faces inequities or disparities when accessing or receiving maternal care. This legislation is an important step towards addressing our nation’s health disparities and promoting equitable maternal healthcare for all. I urge my colleagues in the Senate to pass this critical bill.”

Between 2000 and 2014, the maternal mortality rate in the U.S. increased by 26 percent, while it decreased in nearly every other country. Stark racial disparities in maternal deaths have also persisted, 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 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 legislation is endorsed by: Black Mamas Matter Alliance, Symonette Strategies & Solutions, Center for American Progress, Every Mother Counts, March of Dimes, What to Expect Project, In Our Own Voice: National Black Women’s Reproductive Justice Agenda, Rhimpact (Formerly National Birth Equity Collaborative), Center for Reproductive Rights, National Asian Pacific American Women’s Forum, Planned Parenthood, and American Federation of Teachers.

“No matter where she lives, the color of her skin, or her ability to pay, every mom deserves the respectful, responsive, nurturing and equitable continuum of care and support she needs before, during and after pregnancy to deliver a healthy beginning and healthy future for herself and the baby she loves. Yet too many women in the U.S. live too far from an ob to receive care. Too many gaps in coverage leave too many women unable to afford care, from the crucial pre-pregnancy period through postpartum. Too few women have access to doula and lactation support, dental screenings, mental health counseling, and other services that are vital to maternal and infant health – that reduce risks, save lives, lower healthcare costs. That’s why the WTEP and I are proud to endorse the MOMMIES Act – comprehensive legislation that would provide these vital services and support for moms. We’re grateful to the passionate leadership and tireless efforts and commitment from Senator Booker on behalf of all our moms,” said Heidi Murkoff, author of What to Expect When You’re Expecting and founder of the What to Expect Project.

“With the U.S. in the grips of a devasting maternal mortality crisis which is especially acute for Black moms, we commend Senator Cory Booker and Representative Ayanna Pressley for introducing the Maximizing Outcomes for Moms through Medicaid Improvement and Enhancement of Services (MOMMIES) Act. The legislation will go a long way to improving health outcomes for our nation’s families by extending coverage for people in Medicaid to one year after childbirth, facilitating doula support and improving access to maternity services through telehealth. We urge Congress to take swift action to pass this critical bill,” said Stacey Y. Brayboy, Senior Vice President, Public Policy and Government Affairs, March of Dimes.

“Symonette Strategies & Solutions applauds the reintroduction of the MOMMIES Act. As a boutique consulting firm established to illuminate and amplify the language, lens, and lived experiences of mothers in the development of federal policy, we are thrilled about this landmark bill that would launch the innovative Maternity Care Home Demonstration Project. Distinctively, this bill requires consultation with lactation consultants and peer lactation counselors in the design and implementation of the Project. As we know, breastfeeding is an important modifiable risk for both mothers and babies as it is protective of maternal-infant health across the life course, and provides substantial nutritional, cognitive, emotional, and immunological benefits. By inviting lactation educators to add voice to the conversation and convert insight to influence at the genesis of the Project, we are shaping policy and shifting paradigms that advance breastfeeding and human lactation as central, fundamental components of improving maternal health outcomes thus truly maximizing outcomes for moms,” said Denys Symonette Mitchell of Symonette Strategies & Solutions.

“In Our Own Voice: National Black Women’s Reproductive Justice Agenda is proud to support the reintroduction of the MOMMIES Act and applauds Sen. Cory Booker and Rep. Ayanna Pressley for their continued leadership in combatting the Black maternal health crisis. Black women and birthing people continue to experience alarming rates of pregnancy-related complications and death and we need Reproductive Justice centered solutions more now than ever. A policy recommendation in our 2023 Black Reproductive Justice Policy Agenda, the MOMMIES Act prioritizes key solutions, including expanded access to doula services and coverage of postpartum care. Informed by the Reproductive Justice framework, this bill is a critical step in ensuring Black women, birthing people, and their babies can thrive during pregnancy and beyond,” said Regina Davis Moss, PhD, MPH, MCHES, President and CEO of In Our Own Voice: National Black Women’s Reproductive Justice Agenda.

Full text of the bill can be found here and a summary can be found here.

Rep. Pressley and Sen. Booker originally introduced the bill in 2019.

As a founding member of the Black Maternal Health Caucus, Congresswoman Pressley has been a longtime champion of maternal health and reproductive justice.

• Throughout her time in Congress, Congresswoman Pressley has convened roundtable meetings with maternal health advocates and practitioners in the Massachusetts 7^th Congressional District.
• In May 2023, Congresswoman Pressley and Congresswoman Gwen Moore (WI-04) introduced a resolution recognizing the role doulas play in providing culturally competent maternal health care, addressing racial inequities, and supporting healthier outcomes for mothers and their babies.
• In December 2022, the House passed Congresswoman Pressley’s amendment to strengthen maternal health care for people who are incarcerated.
• In September 2022, Rep. Pressley hosted HHS Secretary Xavier Becerra for a convening on their work to address the Black maternal health crisis and the criminalization of abortion care following the Dobbs decision.
• In November 2021, 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.
• In May 2021, she introduced the Healthy MOMMIES Act, to extend postpartum Medicaid coverage for pregnant people and expand coverage to include culturally competent and community based doula care.
• In March 2020, she first introduced the Justice for Incarcerated Moms Act, legislation to improve maternal health care and support for pregnant individuals who are incarcerated, as part of the Momnibus legislative package. 
• In 2019, she introduced The People’s Justice Guarantee ─ a comprehensive framework to transform the American criminal legal system into one that guarantees justice for all.  She also introduced the Healthy MOMMIES Act with Senator Cory Booker (D-NJ) to expand Medicaid coverage for new moms from 60-days postpartum to one year.

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