MOMMIES Act

Bill Number

S. 4913

Origin Chamber

Senate

Congress

119th Congress, Session 2

Status

Introduced

Latest Action

2026-06-24: Read twice and referred to the Committee on Finance.

Last Updated

2026-07-08T04:08:19Z

AI-Generated Summary

Purpose The legislation, titled the "Maximizing Outcomes for Moms through Medicaid Improvement and Enhancement of Services Act" or "MOMMIES Act," amends Titles XIX and XXI of the Social Security Act. Its goal is to expand and improve Medicaid and Children's Health Insurance Program (CHIP) coverage, benefits, and services for low-income pregnant and postpartum individuals.

Key Provisions

• Extended Coverage Periods: Changes continuous eligibility for pregnant and postpartum individuals from 60 days to at least 1 year after pregnancy ends, with states allowed to offer longer periods. This applies to both Medicaid and CHIP.
• Full Benefits Requirement: Mandates that eligible pregnant and postpartum individuals receive the full scope of Medicaid benefits (equivalent to those for certain low-income adults) for at least 1 year postpartum, regardless of the original eligibility category.
• Oral Health Coverage: Requires states to cover preventive, diagnostic, periodontal, and restorative dental services for pregnant and postpartum individuals in both Medicaid and CHIP.
• Maintenance of Effort Rules: Prohibits states from tightening eligibility rules or reducing benefits for low-income pregnant individuals through 2030 in CHIP and earlier in Medicaid.
• Enhanced Federal Funding: Sets the federal medical assistance percentage at 100% for new costs stemming from the Act's requirements, beginning in 2027.
• Demonstration Project: Creates a 5-year Maternity Care Home Demonstration Project, providing grants to at least 10 states (with geographic diversity) to implement coordinated, culturally appropriate care models involving teams of providers, including doulas and community health workers.
• Primary Care Payment Changes: Reinstates a Medicare-based payment floor for primary care services under Medicaid, extends it to additional providers (such as midwives and certain advanced practice clinicians), and requires managed care plans to comply.
• Doula Services: Directs the Medicaid and CHIP Payment and Access Commission (MACPAC) to study doula coverage and the Centers for Medicare & Medicaid Services (CMS) to issue guidance on expanding access.
• Telehealth and Coverage Gap Studies: Requires Government Accountability Office (GAO) reports on telehealth use for maternity care and gaps in coverage for pregnant, postpartum, and birthing individuals ages 15–49.

Significant Changes to Existing Law

• Extends the postpartum coverage window in multiple sections of the Social Security Act (e.g., sections 1902(e), 1903(v), 2112) from 60 days to 1 year or longer.
• Replaces limited pregnancy-related assistance with a requirement for full-scope benefits.
• Adds new mandatory benefits (oral health services) and demonstration authority (section 1949).
• Introduces payment rate floors, managed care requirements, and maintenance-of-effort protections not previously in effect for these populations.
• Establishes new reporting mandates for MACPAC, CMS, and GAO.

Potential Impacts

• Government Agencies: Increases federal expenditures through the 100% FMAP and demonstration grants; requires states to maintain or expand programs and comply with new reporting and payment rules. CMS, GAO, and MACPAC gain new oversight and study responsibilities.
• Citizens: Expands access to comprehensive maternity, postpartum, oral health, and support services for low-income individuals, with emphasis on coordinated care and equity-focused models.
• International Relations: No direct effects identified.

Main Stakeholders Affected

• Low-income pregnant and postpartum individuals, particularly those from underserved groups.
• State Medicaid and CHIP agencies.
• Healthcare providers and organizations, including obstetricians, midwives, doulas, federally qualified health centers, rural health clinics, and birth centers.
• Federal agencies such as CMS, GAO, and MACPAC.
• Community-based organizations focused on maternal health and equity.

Notable Legal, Constitutional, or Political Implications

• Operates through amendments to the Social Security Act and grants states flexibility via optional extensions and demonstration waivers (e.g., of statewideness and comparability rules).
• Includes explicit requirements for culturally and linguistically appropriate care and equity considerations, without altering core constitutional federal-state funding structures.
• Focuses on addressing disparities in maternal health outcomes through policy changes and studies, with implementation phased starting in 2027.

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

Sponsor

Sen. Booker, Cory A. [D-NJ]

Cosponsors (5)

Sen. Blumenthal, Richard [D-CT], Sen. Warren, Elizabeth [D-MA], Sen. Duckworth, Tammy [D-IL], Sen. Baldwin, Tammy [D-WI], Sen. Smith, Tina [D-MN]

Recent Actions

• 2026-06-24: Read twice and referred to the Committee on Finance.
• 2026-06-24: Introduced in Senate

Bill Versions

• Maximizing Outcomes for Moms through Medicaid Improvement and Enhancement of Services Act — issued 2026-06-24 — PDF (45 pages)