,i #aafth ,,congress #ast ,session ,h4 ,r4 #bgea ,,in ,,the ,,house ,,of ,,representatives ,may #ae1 #bjai,ms4 ,moore 7for herself1 ,ms4 ,haaland1 and ,mrs4 ,dingell7 introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce ,a ,,bill ,to amend title ,,xix of the ,social ,security ,act to provide coverage under the ,medicaid program for services provided by doulas and midwives1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,mamas ,first ,act4 #b4 ,findings ,congress finds the following3 7#a7 ,according to the ,centers for ,disease ,control and ,prevention1 the maternal mortality rate varies drastically for women by race and ethnicity4 ,on average1 there are #ab4g deaths per #ajj1jjj live births for ,white women1 #dc4e deaths per #ajj1jjj live births for ,african-,american women1 #cb4e deaths for ,american ,indian and ,alaskan ,native women1 and #ad4d deaths per #ajj1jjj live births for women of other ethnicities4 ,while maternal mortality disparately impacts ,african-,american women and indigenous women1 this urgent public health crisis traverses race1 ethnicity1 socioeconomic status1 educational background1 and geography4 7#b7 ,united ,states maternal mortality rates are the highest in the developed world and are increasing rapidly4 7#c7 ,many of these maternal deaths are likely preventable4 7#d7 ,according to the ,national ,institutes of ,health1 doula-assisted mothers are four times less likely to have a low-birth-weight baby1 two times less likely to experience a birth complication involving themselves or their baby1 and significantly more likely to initiate breastfeeding4 7#e7 ,midwife-led care is associated with cost savings1 decreased rates of intervention1 lower cesarean rates1 lower preterm birth rates1 and healthier outcomes for mothers and babies4 7#f7 ,midwives may practice in any setting1 including the home1 community1 hospitals1 clinics1 or health units4 #c4 ,medicaid coverage of services provided by doulas and midwives 7a7 ,in general ,section #aije of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7 is amended-- 7#a7 in subsection 7a7-- 7,a7 in paragraph 7#bi71 by striking and at the end2 7,b7 by redesignating paragraph 7#cj7 as paragraph 7#ca72 and 7,c7 by inserting after paragraph 7#bi7 the following new paragraph3 7#cj7 services1 including prenatal1 delivery1 and postpartum services1 provided by doulas and midwives 7as those terms are defined in subsection 7ff77 to the extent authorized under ,state law2 and 2 and 7#b7 by adding at the end the following new subsection3 7ff7 ,doulas and midwives defined ,for purposes of subsection 7a77#cj73 7#a7 ,doulas defined ,the term doula means an individual who-- 7,a7 is certified by an organization1 which has been established for not less than five years and which requires the completion of continuing education to maintain such certification1 to provide non-medical advice1 information1 emotional support1 and physical comfort to an individual during such individual's pregnancy1 childbirth1 and postpartum period2 and 7,b7 maintains such certification by completing such required continuing education4 7#b7 ,midwives defined 7,a7 ,in general ,the term midwife means a certified midwife1 certified professional midwife1 licensed midwife1 and ,tribal-recognized midwife4 7,b7 ,certified midwife ,for purposes of subparagraph 7,a71 the term certified midwife means an individual who is certified by the ,american ,midwifery ,certification ,board to practice midwifery4 7,c7 ,certified professional midwife ,for purposes of subparagraph 7,a71 the term certified professional midwife means an individual who-- 7i7 is certified by the ,north ,american ,registry of ,midwives to practice midwifery for normal1 low-risk pregnancies and childbirths2 7ii7 completes-- 7,i7 a midwifery education program accredited by the ,midwifery ,education and ,accreditation ,council or any other entity recognized by the ,department of ,education2 or 7,,ii7 the requirements to obtain a ,midwifery ,bridge ,certificate from the ,north ,american ,registry of ,midwives2 and 7iii7 maintains the certification described in clause 7i7 by completing any required continuing education for such certification4 7,d7 ,licensed midwife ,for purposes of subparagraph 7,a71 the term licensed midwife means1 with respect to a ,state1 an individual who is licensed under ,state law to practice midwifery4 7,e7 ,tribal-recognized midwife ,for purposes of subparagraph 7,a71 the term ,tribal-recognized midwife means an individual who is recognized by an ,indian tribe 7as defined in section #d of the ,indian ,health ,care ,improvement ,act7 to practice midwifery for such tribe4 4 7b7 ,requiring mandatory coverage under ,state plan ,section #aijb7;a77#aj77;,a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7a77#aj77;,a77 is amended1 in the matter preceding clause 7i71 by striking and 7#bi7 and inserting 7#bi71 and 7#cj74 7c7 ,effective date 7#a7 ,in general ,subject to paragraph 7#b71 the amendments made by this section shall apply with respect to medical assistance furnished on or after ,january #a1 #bjbj4 7#b7 ,exception for ,state legislation ,in the case of a ,state plan under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 that the ,secretary of ,health and ,human ,services determines requires ,state legislation in order for the respective plan to meet any requirement imposed by amendments made by this section1 the respective plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet such an additional requirement before the first day of the first calendar quarter beginning after the close of the first regular session of the ,state legislature that begins after the date of the enactment of this ,act4 ,for purposes of the previous sentence1 in the case of a ,state that has a #b-year legislative session1 each year of the session shall be considered to be a separate regular session of the ,state legislature4