Healthy Moms and Babies Act

Bill Number

S. 2289

Origin Chamber

Senate

Congress

119th Congress, Session 1

Policy Area

Health

Status

Introduced

Latest Action

2026-03-19: Committee on Health, Education, Labor, and Pensions. Hearings held.

Last Updated

2026-04-09T16:07:49Z

AI-Generated Summary

Purpose of the Legislation

The Healthy Moms and Babies Act (S. 2289) seeks to improve maternal and perinatal health outcomes for women covered by Medicaid and the Children's Health Insurance Program (CHIP). It focuses on enhancing care coordination, reducing unnecessary medical procedures like cesarean sections, addressing racial and ethnic disparities, expanding access to supportive services (such as doulas and telehealth), and strengthening data collection on social factors affecting health. Overall, it aims to lower maternal mortality and severe morbidity rates while promoting equitable, high-quality care during pregnancy and up to one year postpartum.

Key Provisions

The bill introduces multiple measures across Medicaid, CHIP, and related public health programs. Key elements include:

• Quality Reporting and Improvement:
• Requires states to report annually (starting 2027) on low-risk cesarean delivery rates for Medicaid-eligible pregnant women, including quality improvement activities to reduce these rates and address disparities.
• Mandates hospitals participating in Medicare to report data on Nulliparous, Term, Singleton, Vertex (NTSV) cesarean rates, incorporating this into hospital quality programs by 2027.

• Care Coordination and Health Homes:
• Allows states (starting 2028) to offer a "maternity health home" option under Medicaid for pregnant and postpartum women, providing coordinated care through designated providers or teams (e.g., doctors, midwives, doulas). This includes personalized care plans, social support, and payments via per-member-per-month or other models.
• Provides $50 million in planning grants to states (fiscal years 2026–2028) to develop these programs.

• Workforce and Training Enhancements:
• Establishes a national expert group to evaluate and recommend best practices for birthing care, including training on reducing cesareans, incorporating doulas and midwives, and addressing disparities.
• Directs the Medicaid and CHIP Payment and Access Commission (MACPAC) to study doula and community health worker roles, followed by guidance on reimbursing doula services under Medicaid to ensure living wages and access in underserved communities.

• Telehealth and Technology Expansion:
• Awards grants to states for 4-year demonstration projects (starting 18 months after enactment) to integrate telehealth for maternal care, targeting rural or underserved areas and disparities; includes reporting on access and outcomes.
• Requires a report on Medicaid coverage of remote monitoring devices (e.g., blood pressure cuffs) and their impact on maternal/child health, with updated state resources.

• Guidance and Support Programs:
• Issues guidance on care coordination (e.g., integrating behavioral health, social needs screening), community-based programs (e.g., group prenatal care, home visiting), and addressing social determinants of health (e.g., housing, nutrition) for pregnant/postpartum women.
• Establishes a National Advisory Committee on Reducing Maternal Deaths (up to 41 members, including federal officials and experts) to develop resources for providers on screening, risk reduction, and quality checklists; updates every 3 years.
• Expands grants for perinatal quality collaboratives to reduce cesareans and increase vaginal births after cesarean, focusing on data-driven, collaborative strategies.

• Data Collection and Studies:
• Mandates collection of social determinants of health data (e.g., using ICD-10 codes for factors like poverty or education) in Medicaid/CHIP, with $90 million appropriated for federal/state implementation (starting 4 years after enactment).
• Requires studies by the Government Accountability Office (GAO) on Medicaid payment rates for births, racial disparities in cesareans, and transfer payments between facilities.
• Strengthens Payment Error Rate Measurement (PERM) audits for Medicaid (biennial starting 2027), requiring states with high error rates (>15%) to submit reduction plans.

• Other Measures:
• Extends postpartum coverage considerations and integrates mental health/substance use support.
• Promotes learning collaboratives among states for sharing best practices on social needs.

Appropriations are authorized for specific programs (e.g., $50 million for planning grants, $40 million for data systems, $1 million annually for social determinants reporting).

Significant Changes to Existing Law

• Amendments to Social Security Act (Titles XIX and XXI): Adds mandatory reporting on maternal/perinatal health quality measures; introduces a new "maternity health home" section (1945B) with waivers for statewideness/comparability; expands section 1946 on health disparities to include social determinants data collection; requires biennial PERM audits and error reduction plans.
• Public Health Service Act Changes: Inserts a new section (317L-2) for a national birthing practices expert group; amends section 317K to fund perinatal quality collaboratives for reducing cesareans.
• Medicare Updates: Requires hospital reporting of NTSV cesarean rates under section 1866 and incorporates into quality payments (section 1886).
• New Entities and Reports: Creates the National Advisory Committee on Reducing Maternal Deaths; mandates multiple GAO, CMS, and MACPAC reports/studies not previously required.
• Implementation Timelines: Phased rollout (e.g., guidance within 1–3 years, demonstrations within 18 months, data collection after 4 years), with privacy protections emphasized.

These changes build on existing frameworks like maternal mortality reviews and telehealth flexibilities but impose new mandatory reporting, funding, and coordination requirements.

Potential Impacts

• On Government Agencies: Centers for Medicare & Medicaid Services (CMS) will face increased administrative burdens for guidance issuance, grant administration, audits, and data systems (with $90 million+ in appropriations). States must invest in reporting, training, and program development, potentially reducing improper payments but raising short-term costs; GAO and MACPAC gain new study mandates.
• On Citizens: Pregnant and postpartum Medicaid/CHIP enrollees (especially in underserved, rural, or minority communities) could benefit from better access to coordinated care, telehealth, doulas, and social supports, potentially lowering cesarean rates, maternal morbidity, and disparities. However, not all states may opt into new programs, and data collection could improve personalized care but requires privacy safeguards.
• On International Relations: No direct impacts; the bill is domestic-focused on U.S. health programs.
• Broader Effects: Could reduce overall healthcare costs through preventive measures (e.g., fewer cesareans) and better outcomes, but implementation may strain state budgets without full federal funding.

Main Stakeholders Affected

• Pregnant and Postpartum Women: Primary beneficiaries, particularly low-income, minority, rural, or high-risk individuals under Medicaid/CHIP, gaining from enhanced care and supports.
• Healthcare Providers: Hospitals, obstetricians, midwives, doulas, community health workers, and managed care organizations must adapt to new reporting, training, and coordination standards; potential for increased reimbursements (e.g., doulas).
• States and Medicaid Agencies: Responsible for implementation, reporting, and optional programs; affected by grants, audits, and data requirements.
• Federal Agencies: CMS (guidance, grants, audits), Department of Health and Human Services (expert groups, studies), and GAO/MACPAC (research).
• Advocacy and Community Groups: Maternal health organizations, perinatal collaboratives, and consumer advocates involved in consultations and program design.
• Hospitals and Insurers: Face new quality metrics and payment studies, with incentives for improvement.

Notable Legal, Constitutional, or Political Implications

• Legal: Strengthens compliance with existing privacy laws (e.g., HIPAA) in data collection on social determinants, with explicit protections against disclosure. Waivers for state programs promote flexibility but require Secretary approval, potentially leading to legal challenges if deemed inconsistent with federalism principles. Emphasizes voluntary participation (e.g., for doulas/providers) to avoid coercion claims.
• Constitutional: Aligns with Congress's spending power under the General Welfare Clause by conditioning federal funds on reporting and quality improvements; no apparent First Amendment or equal protection issues, as it targets disparities without mandating speech or discrimination.
• Political: Bipartisan sponsorship (Grassley and Hassan) signals broad support for maternal health equity, but state opt-ins and appropriations could spark debates on federal overreach or funding adequacy. May influence future budgets by highlighting Medicaid's role in public health crises like maternal mortality, potentially pressuring states to address racial inequities amid ongoing political divides on healthcare access.

This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.

Sponsor

Sen. Grassley, Chuck [R-IA]

Cosponsors (1)

Sen. Hassan, Margaret Wood [D-NH]

Recent Actions

• 2026-03-19: Committee on Health, Education, Labor, and Pensions. Hearings held.
• 2025-07-15: Read twice and referred to the Committee on Finance.
• 2025-07-15: Introduced in Senate

Bill Versions

• Healthy Moms and Babies Act — issued 2025-07-15 — PDF (80 pages)