Sponsors (4)
The bill creates a new Medicaid maternity health home benefit that can improve coordinated pregnancy and postpartum care and funds initial implementation, but access depends on optional State adoption, temporary funding, and waiver flexibility that may produce uneven coverage and administrative burdens.
Pregnant Medicaid enrollees can enroll in a maternity health home that coordinates pregnancy care through up to 1 year postpartum, improving continuity and quality of maternal care.
States receive a temporary 15 percentage point FMAP increase (capped at 90%) for the first four fiscal quarters after approval, lowering initial state costs for implementing maternity health homes.
Pregnant enrollees gain individualized, culturally and linguistically appropriate care plans that include behavioral health, social supports, and community resources, broadening access to nonmedical supports linked to better maternal outcomes.
Pregnant Medicaid enrollees may not get these services if their State does not adopt the optional maternity health home benefit, leaving access uneven across States.
Pregnant people whose Medicaid coverage is limited to pregnancy-related-only coverage during the 365 days postpartum are excluded from eligibility, leaving some postpartum people without coordinated services.
Waiver of statewide and comparability requirements lets States restrict availability geographically or by population, creating potential for unequal access within and between States.
Based on analysis of 2 sections of legislative text.
Establishes a voluntary Medicaid state-plan option for maternity health homes to coordinate pregnancy care and up to one year postpartum for eligible enrollees.
Introduced May 13, 2025 by Zach Nunn · Last progress May 13, 2025
Creates a voluntary Medicaid state-plan option that lets states set up "maternity health homes" to coordinate pregnancy and postpartum care. Eligible pregnant people enrolled in Medicaid can enroll with a designated provider or be served by providers who opt into the program to receive coordinated care during pregnancy and for up to one year after pregnancy ends. States must adopt the option through a state plan amendment after consulting providers and pregnant or formerly pregnant enrollees; the Secretary of Health and Human Services will issue standards for qualifying maternity health homes and designated provider teams, including requirements for care coordination, individualized care plans, access to specialists and programs, and consideration of payment-method adjustments. The option becomes available two years after enactment.