By: Tanesha Mondestin and Kay Johnson
Maternal health continues to be a priority for many Members of Congress. We previously scanned maternal health legislation that Members of Congress may consider in the 2022 “Lame Duck” session. We revisited this topic this election year to consider proposals pending in the 118th Congress as their chance of passage are set to expire on December 31, 2024. While many legislative proposals designed to improve maternal and infant health were introduced in this Congress, none have yet been enacted to date.
The maternal health crisis has drawn lawmaker attention in recent years, especially the impact on Black and Indigenous mothers, who experience maternal mortality rates much higher than other racial/ethnic groups. We also know the broader category of pregnancy-related deaths are largely preventable. So, let’s take a look at the pending bills to address maternal and infant health that Congress may revisit after the November election during the Lame Duck session before the new Members of Congress are sworn in.
Maternal Health Legislation in the 118th Congress
We cataloged maternal health bills introduced in the 118th Congress into four main categories: maternal health, reproductive and women’s health, broad maternal and infant health, and social determinants/drivers of health related maternal and infant well-being. The main focus of this blog is maternal health.
Maternal Health Bills
Thirty-nine unique proposals regarding maternal health were written and introduced in the 118th Congress, totaling up to 70 bills when identical companion legislation from the opposite chambers are included. (To see a table, click here.) Eighteen of the 39 proposals named at least one Democratic and one Republican co-sponsor, illustrating bipartisan support for policies to reduce maternal mortality.
The Black Maternal Health Momnibus Act, the most comprehensive of the proposals, was reintroduced in the 118th Congress. The Momnibus encompasses 13 componentbills introduced by members of the Black Maternal Health Caucus, with 193 House co-sponsors and 32 Senate co-sponsors. Championed by Caucus Co-Chairs Representative Alma Adams and Representative Lauren Underwood, the Momnibus Act aims to improve maternal health with strategies to improve health care quality (e.g., workforce, payment, data) and approaches for reducing social risk factors that can improve outcomes (e.g., funding for community-based organizations). It also addresses maternal health issues for specific groups of women, such as those who are veterans, in military service, incarcerated, or in need of substance use services. While most components of the Momnibus were not enacted into law, Congress made investments in programs and initiatives designed to fulfill some of the Momnibus goals through the appropriations process (see more in our companion appropriations blog here).
Four pending bills in this group give attention to Medicaid. The Advancing Maternal Health Equity under Medicaid Act proposes to increase federal matching rates for maternity and perinatal care providers. Two bills focus on coordinated care via maternity health homes. Notably, in the 116th and 117th Congress, separate bills successfully gave states the option to extend Medicaid postpartum coverage from 60 days to one full year, later making the option permanent. All but a few states have implemented the postpartum extension to a full 12 months. The MOMMIES Act, introduced in the 118th Congress, would go further, requiring every state to extend Medicaid coverage to a full year postpartum.
Other bills in this overall maternal health category address related purposes, such as continuation of programs that focus on communities with high need and/or high mortality rates, as well as surveillance and research to better understand the trends and needs.
Other Related Legislation
Broad Maternal & Infant Health. Twenty-three bills, (5 with bipartisan co-sponsors) covered 20 unique proposals for moms and infants designed to: support breastfeeding and nutrition, boost pediatric primary care rates in Medicaid, increase affordability of diapers, increase funding to communities with high rates of infant mortality, remove coverage barriers for immigrants, and address specific issues (e.g. oral health, congenital syphilis, increase research on stillbirths).
Reproductive & Women’s Health. Lawmakers introduced a total of 27 bills designed to: improve affordability of menstrual products, ensure access to contraception and abortion, protect confidentiality of personal health records and data, increase access to services related to infertility, fund professional education, and support public education regarding reproductive health services.
SDOH Maternal & Infant Health. Twelve bills with seven unique proposals seek to: improve paid parental leave and child tax credits, increase affordability of child care, reduce the employment eligibility period for receiving family and medical leave, designate Healthy Disparity Zones. (Read more about Medicaid 1115 demonstrations to address health-related social needs here.)
Conclusion
Improved federal policies to support maternal health and to fund essential programs requires Congressional action. The Lame Duck session will give lawmakers the opportunity to pass legislation and appropriations in the final months of the 118th Congress. Adopting new maternal health policies and making investments in programs that work is an essential step to ensure that all pregnant people, mothers, and infants have the opportunity for health and survival.
Kay Johnson has been a leader in health policy for women, children, and families for 40 years, focusing on Medicaid and MCH policy at the federal and state levels since 1984 and advising more than 45 state health and/or Medicaid agencies. Her work on this analysis of federal maternal health policy was supported by the David and Lucile Packard Foundation.