Creates federal support to expand access to freestanding birth centers and to test new Medicaid payment approaches for low‑risk pregnancy care. It authorizes a competitive grant program to start or expand birth centers in underserved areas and establishes a Medicaid demonstration so States can test prospective payment and other payment models for Medicaid‑eligible, low‑risk pregnant people.

The Health Resources and Services Administration will award birth center grants to cover facility work, equipment, accreditation, and licensure; the Department (CMS) will run the Medicaid demonstration, offering planning and demonstration grants, publishing participation and payment guidance, permitting necessary waivers, and requiring State and Federal reporting on outcomes and costs.