Doula Medicaid Project

About the Doula Medicaid Project

The National Health Law Program’s Doula Medicaid Project seeks to improve health outcomes for pregnant Medicaid enrollees by ensuring that all pregnant individuals enrolled in Medicaid who want access to a doula will have one.

Low-income women are at the highest risk of poor birth outcomes in the United States, and women of color, especially Black women, are especially vulnerable. Doula care is among the most promising approaches to combating disparities in maternal health. Women receiving doula care have been found to have improved health outcomes for both themselves and their infants, including higher breastfeeding initiation rates, fewer low-birth weight babies, and lower rates of cesarean sections. Doulas can also help reduce the impacts of racism and racial bias in health care on pregnant women of color by providing individually tailored, culturally appropriate, and patient centered care and advocacy.

We are lawyers, researchers, and policy advocates. We are not doulas. As such, we seek to do all our work in partnership with and with the guidance of community doula groups, doula collectives, and individual doulas, especially Black doulas and Black-led doula groups, as well as doulas and doula groups serving low-income clients.

To achieve the goal of Medicaid coverage of doula care, we are engaged in advocacy work on various fronts, including:

  • Working with doulas and other stakeholders to identify and overcome barriers to creating a sustainable and equitable Medicaid coverage of doula care program;
  • Educating legislators and other stakeholders about the importance of expanding full-spectrum Medicaid coverage of doula care, including doula support for prenatal care, labor/delivery, postpartum care, miscarriage management, and abortion;
  • Information gathering and sharing with states around the country who have proposed legislation relating to Medicaid coverage of doula care; and
  • Advocating for state legislation creating a Medicaid coverage of doula care program, initially in California and then promoted as a model strategy in other states.

If you have any questions or comments, or would like more information, please contact NHeLP Senior Staff Attorney Amy Chen at [email protected].

Learn more about this artwork created by Megan Smith: Watch a short video about the evolution of the design and explore their Repeal Hyde Art Project.

Doula Report

The Doula Medicaid Project is proud to publish our report Building A Successful Program for Medi-Cal Coverage For Doula Care: Findings From A Survey of Doulas in California. The report is the distillation of a survey of doulas across California, as well as a series of focus groups held at four locations across the state. We hope that this report provides doulas, advocates, agencies, and other stakeholders with the information and insight needed to expand access to doula care in an equitable, inclusive, and sustainable way, both in California and across the nation.

We have also published an assortment of one-page fact sheets intended to introduce advocates, agencies, and other stakeholders to the important work of doulas.

Current State Doula Medicaid Efforts

The National Health Law Program’s Doula Medicaid Project is tracking current state doula Medicaid efforts, including states that have enacted legislation and are in the process of implementing Medicaid coverage for doula care. We have compiled our information into the chart below, which we hope will be a helpful resource for doulas, advocates, researchers, legislators, and other stakeholders working on this issue. We are doing our best to update this chart on a regular basis.  If you have any corrections, comments, or questions about this chart, please contact NHeLP Health Policy Analyst Alexis Robles-Fradet at [email protected].
We would like to express our gratitude to all the doulas and advocates we spoke with in compiling this chart, including Andrea Berry, Ashley Black, Gerria Coffee, Yuki Davis, Twylla Dillion, Rebecca Elliott, Sara Finger, Ireta Gasner, Christina Gebel, Tony Gillespie, Kayla Goldfarb, Ashley Hill Hamilton, Danita Jackson, Thunwa Klaihathai, Enjolie Lafaurie, Samantha Lew, Kyesha Lindberg, Katharine London, Michelle Ludwig, Raquel Mazon Jeffers, Wendy McWeeny, Fatima Modaba, Ashley Nguyen, Raeben Nolan, Maria Noyes, Quatia Osorio, Breechelle Parker, Chanel Porchia-Albert, Laura Register, Anjali Salvador, Quentin Savwoir, Elizabeth Simmons, Nan Strauss, Kenda Sutton-El, Sarah Teel, Kara Van de Grift, Jackie Vaughn, Kelly Vyzral, Steven Wagner, Sunny Lu Williams, and Elizabeth Wood.
This chart was compiled by Sarah Hart, NHeLP fall 2021 intern and Georgetown law student.
KEY TO CURRENT STATUS COLORS
Green = Actively reimbursing doula services on Medicaid plans
Yellow = In the process of implementing Medicaid doula benefits
Blue = Action taken that is adjacent to Medicaid doula benefits (e.g., pilot program, doula registry)
Purple = Action proposed but no progress

Archive of State and Federal Legislation

The Doula Medicaid Project tracked state and federal legislative efforts related to expanding access to doula care in 2019, 2020, and 2021. We have archived our bill tracking charts, and they are available for download in PDF form below. If you have any questions about these charts, please contact NHeLP Health Policy Analyst Alexis Robles-Fradet at [email protected].

 

State Legislation Related to Expanding Doula Access

Federal Legislation Related to Expanding Doula Access

  • Coming soon!

National Health Law Program Resources

California

 

National

Other Resources