Sponsors (73)
Official title: To direct the Administrator of the Centers for Medicare & Medicaid Services to implement the Perinatal Care Alternative Payment Model Demonstration Project to test various payment models with respect to maternity care provided to pregnant and postpartum individuals, and for other purposes.
Introduced May 19, 2026 by Janice D. Schakowsky · Last progress May 19, 2026
The bill creates a Medicaid/CHIP demonstration to test team-based, community-inclusive perinatal care that could improve maternal outcomes and expand care choices, but it brings administrative costs, possible higher Medicaid spending, and risks of uneven implementation that could leave some providers and communities worse off.
Pregnant and postpartum Medicaid/CHIP enrollees — especially high-risk patients and those with mental health or substance-use needs — would gain access to coordinated, team-based perinatal care (including behavioral health and community supports), improving maternal outcomes.
States can test alternative payment models that cover nonhospital birth settings and community-based supports (e.g., doulas, perinatal workers), which could lower delivery system costs and expand birth-setting choice, benefiting rural communities and state budgets.
The demonstration requires evaluation and reporting to Congress, producing evidence policymakers can use to scale effective models nationally.
Shifting to new Medicaid/CHIP payment models could financially disadvantage some providers if quality metrics are unclear, prompting service reductions in underserved or rural areas.
Expanding covered services (doulas, perinatal workers, behavioral health) may increase Medicaid/CHIP spending, potentially raising costs for taxpayers or requiring additional appropriations.
States and providers will face administrative burdens and implementation costs to apply for and run new demonstration payment models.
Based on analysis of 2 sections of legislative text.
Creates a CMS demonstration (FY2027–2031) allowing states to test Medicaid/CHIP perinatal alternative payment models, requiring stakeholder engagement, evaluation, and reporting.
Creates a CMS-led Perinatal Care Alternative Payment Model Demonstration for fiscal years 2027–2031 that lets states test new Medicaid and CHIP payment and coverage approaches for maternity care for pregnant and postpartum individuals. The demonstration must engage a wide set of stakeholders, allow varied care teams and settings, include social and behavioral supports, evaluate impacts on health outcomes and spending, and report findings publicly and to Congress. States apply to participate; HHS must design, run, evaluate, and report on the demonstration, emphasizing inclusion of groups with elevated maternal morbidity and mortality and measuring clinical, equity, spending, and patient experience outcomes.