Sponsors (2)
Official title: Amend titles XIX and XXI of the Social Security Act to improve maternal health coverage under Medicaid and CHIP, and for other purposes.
Introduced July 15, 2025 by Charles Ernest Grassley · Last progress July 15, 2025
The bill aims to improve maternal health and equity by expanding postpartum Medicaid coverage, community supports, data collection, and quality standards, but delivers those gains unevenly and at the cost of substantial new reporting, administrative burdens, and potential state/federal spending increases that could produce geographic disparities unless funded and implemented carefully.
Pregnant and postpartum Medicaid enrollees will have guaranteed continuous Medicaid coverage and coordinated care pathways for up to 12 months postpartum (improving access to primary, specialty, maternity, and behavioral health services).
Medicaid enrollees will gain expanded access to community-based maternal supports (doulas, community health workers, group prenatal care, home visiting), and better-integrated behavioral health and substance use services within maternity care.
States, providers, and federal agencies will get stronger data, reporting, and measurement tools (perinatal quality measures, race/ethnicity-disaggregated measures, NTSV C-section reporting, SDOH collection) to identify gaps, target interventions, and monitor racial and geographic disparities in maternal outcomes.
States, Medicaid programs, hospitals, and providers face substantial new or increased costs (coverage expansions, longer postpartum eligibility, grants, reporting, workforce payments) that could raise federal/state spending and create trade-offs for other services or provider payments.
The bill creates wide additional administrative, reporting, and compliance burdens for HHS, State Medicaid agencies, hospitals, and clinicians (new data collection, quality reporting, audits, mitigation plans, collaboratives) that will consume staff time and require IT and process changes.
Many changes are optional, advisory, or contingent on future guidance, appropriations, or state uptake, which risks uneven adoption and geographic disparities so benefits may concentrate in some states or communities while others see little improvement.
Based on analysis of 32 sections of legislative text.
Strengthens Medicaid/CHIP maternal and perinatal care via studies, guidance, reporting, grants/demos, a maternity health home option, quality measures, and SDOH data collection supports.
Directs HHS and CMS to strengthen Medicaid and CHIP coverage, data, quality measurement, and state program options to improve maternal and perinatal outcomes. It requires studies and reports on remote monitoring devices and social determinants of health (SDOH) data collection, issues guidance and learning collaboratives for States, funds competitive grants and telehealth demonstrations, and creates a new optional Medicaid maternity health home state-plan authority effective April 1, 2028. Requires expanded Medicaid and Medicare reporting on cesarean rates (including NTSV C-sections), establishes perinatal quality collaborative grant authority, forms advisory and expert committees on best birthing practices, and increases CMS oversight of improper payments in Medicaid through biennial PERM audits and state mitigation plans. Many actions include deadlines for guidance, reports, and demonstrations over 1–3 years and some authorized funding for data and pilot activities.