Mamas First Act

Elizabeth Warren

Democrat · MA · Senator

Source: Congress.gov · FEC

No cosponsors on record. Bills can pass without cosponsors — this often means the sponsor introduced the bill alone, either because it's a messaging bill, a chairman's mark, or simply early in the legislative cycle.

Read twice and referred to the Committee on Finance.

2026-07-15

Source: Congress.gov

The proposal would expand Medicaid coverage to include services from doulas (birth coaches), midwives, and lactation consultants who help pregnant women and new mothers. This would allow low-income pregnant women and families covered by Medicaid to access these support services without paying out of pocket. The change aims to improve maternal and infant health outcomes by making these services more accessible to people who might not otherwise afford them.

AI-assisted summary generated from the official bill metadata (title, subjects, actions) sourced from Congress.gov. Cached and reviewed. Always verify against the official text linked below.

119 S4986 IS: Mamas First Act U.S. Senate 2026-07-15 text/xml EN Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain. II119th CONGRESS2d SessionS. 4986IN THE SENATE OF THE UNITED STATESJuly 15, 2026Ms. Warren introduced the following bill; which was read twice and referred to the Committee on FinanceA BILLTo amend title XIX of the Social Security Act to provide coverage under the Medicaid program for services provided by doulas, midwives, and lactation support providers, and for other purposes.1.Short titleThis Act may be cited as the Mamas First Act.2.FindingsCongress finds the following:(1)According to the Centers for Disease Control and Prevention, the maternal mortality rate varies drastically for women by race and ethnicity. On average, there are 13.6 deaths per 100,000 live births for White women, 45 deaths per 100,000 live births for Black women, and 13.9 deaths per 100,000 live births for Hispanic women. For American Indian and Alaskan Native women, the National Council of Urban Indian Health estimates there are 54.6 deaths per 100,000 live births. While maternal mortality most disparately impacts Black women and Indigenous women, this urgent public health crisis traverses race, ethnicity, socioeconomic status, educational background, and geography.(2)United States maternal mortality rates are the highest among similarly economically situated countries and continue to increase.(3)Four out of 5 of these maternal deaths are likely preventable.(4)According to the National Institutes of Health, individuals who have doula support during their pregnancy are 4 times less likely to have a low-birth-weight baby, 2 times less likely to experience a birth complication involving themselves or their baby, and significantly more likely to initiate breastfeeding.(5)Midwifery-led care is associated with cost savings, decreased rates of intervention, lower rates of cesarean birth, lower preterm birth rates, and healthier outcomes for mothers and babies.(6)Midwives may practice in any setting, including the home, community, hospitals, birth centers, clinics, or health units.3.Medicaid coverage of services provided by doulas, midwives, and lactation support providers(a)In generalSection 1905 of the Social Security Act (42 U.S.C. 1396d) is amended—(1)in subsection (a)—(A)in paragraph (31), by striking and at the end;(B)by redesignating paragraph (32) as paragraph (33); and(C)by inserting after paragraph (31) the following new paragraph:(32)services and care, including prenatal, labor, and postpartum care, that is provided in a culturally congruent manner by doulas, midwives, tribal midwives, and lactation support providers (as those terms are defined in subsection (ll)), that is provided in the home, community, a hospital, birth center, clinic, or health unit, or is furnished via telehealth to the extent authorized under State law; and ; and(2)by adding at the end the following:(ll)Doulas, midwives, tribal midwives, and lactation support providers definedFor purposes of subsection (a)(32):(1)Doula definedThe term doula means an individual who—(A)(i)is certified by an organization which requires the completion of continuing education to maintain such certification, to provide non-medical advice, information, emotional support, and physical comfort to an individual during such individual’s pregnancy, childbirth, and postpartum period; and(ii)maintains such certification by completing such required continuing education;(B)can provide a recommendation from at least—(i)three different former clients for whom the prospective doula provided doula services (either paid or volunteer) within the last 5 years; or(ii)two different licensed health care providers (including physicians, midwives, social workers, or nurses) who observed the prospective doula providing doula services within the last 5 years; or(C)is authorized to serve as a Medicaid provider of doula services under the State plan under this title (or a waiver of such plan) of the individual's State.(2)Midwife definedThe term midwife means a midwife who—(A)is authorized to serve as a Medicaid provider of midwife services under the…

State plan under this title (or a waiver of such plan) of the individual's State; or(B)meets at a minimum the international definition of the midwife and global standards for midwifery education as established by the International Confederation of Midwives.(3)Tribal midwife definedThe term tribal midwife means an individual who—(A)is authorized to serve as a Medicaid provider of tribal midwife services under the State plan under this title (or a waiver of such plan) of the individual's State; or(B)is recognized by an Indian tribe (as defined in section 4 of the Indian Health Care Improvement Act (25 U.S.C. 1603)) to practice midwifery for such tribe.(4)Lactation support provider definedThe term lactation support provider means an individual who—(A)is authorized to serve as a Medicaid provider of lactation support services under the State plan under this title (or a waiver of such plan) of the individual's State;(B)has completed at least 20 hours of foundational training based on the World Health Organization/United Nations Children's Fund lactation counseling training blueprint, or an equivalent training; or(C)is recognized within any category on the Lactation Support Provider Descriptor chart published by the U.S. Breastfeeding Committee-affiliated Lactation Support Provider Constellation..(b)Requiring mandatory coverage under State planSection 1902(a)(10)(A) of the Social Security Act (42 U.S.C. 1396a(a)(10)(A)) is amended, in the matter preceding clause (i), by striking and (30) and inserting (30), and (32).(c)Cost sharing prohibitionTitle XIX of the Social Security Act (42 U.S.C. 1396 et seq.) is amended—(1)in subsections (a)(2)(B) and (b)(2)(B) of section 1916 (42 U.S.C. 1396o(a)(2)(B), (b)(2)(B)), by inserting after the comma at the end and services and care (including prenatal, labor, and postpartum care) provided by a doula, midwife, tribal midwife, or lactation support provider (as those terms are defined in section 1905(ll)),; and(2)in section 1916A(b)(3)(B)(iii) (42 U.S.C. 1396o–1(b)(3)(B)(iii)), by inserting before the period at the end , and services and care (including prenatal, labor, and postpartum care) provided by a doula, midwife, tribal midwife, or lactation support provider (as those terms are defined in section 1905(ll)).(d)Effective date(1)In generalSubject to paragraph (2), the amendments made by this section shall apply with respect to medical assistance furnished on or after January 1, 2027.(2)Exception for State legislationIn the case of a State plan under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) that the Secretary of Health and Human Services determines requires State legislation in order for the respective plan to meet any requirement imposed by amendments made by this section, the respective plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet such an additional requirement before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of the enactment of this Act. For purposes of the previous sentence, in the case of a State that has a 2-year legislative session, each year of the session shall be considered to be a separate regular session of the State legislature.

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