,i  #aaf? ,,congress  #a/ ,session  ,h4 
,r4 #bgea  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,may #ae1 #bjai,ms4   
,moore 7= h]self1 ,ms4 ,haal&1 & ,mrs4  
,d+ell7 introduc$ ! foll[+ bill2 :i* 0  
ref]r$ to ! ,committee on ,en]gy &      
,comm]ce  ,a ,,bill  ,to am5d title     
,,xix ( ! ,social ,security ,act to     
provide cov]age "u ! ,m$icaid program = 
s]vices provid$ by d\las & midwives1 & =
 o!r purposes4  #a4 ,%ort title ,?is    
,act may be cit$ z ! ,mamas ,fir/ ,act4 
#b4 ,f9d+s ,congress f9ds ! foll[+3     
7#a7 ,accord+ to ! ,c5t]s = ,disease    
,control & ,prev5tion1 ! mat]nal        
mortality rate v>ies dra/ically = wom5  
by race & e?nicity4 ,on av]age1 !re are 
#ab4g dea?s p] #ajj1jjj live bir?s =    
,:ite wom51 #dc4e dea?s p] #ajj1jjj live
 bir?s = ,african-,am]ican wom51 #cb4e  
dea?s = ,am]ican ,indian & ,alaskan     
,native wom51 & #ad4d dea?s p] #ajj1jjj 
live bir?s = wom5 ( o!r e?nicities4     
,:ile mat]nal mortality disp>ately      
impacts ,african-,am]ican wom5 &        

indig5\s wom51 ?is urg5t public heal?   
crisis trav]ses race1 e?nicity1         
socioeconomic /atus1 educational        
backgr\nd1 & geography4  7#b7 ,unit$    
,/ates mat]nal mortality rates are !    
highe/ 9 ! develop$ _w & are increas+   
rapidly4  7#c7 ,_m ( ^! mat]nal dea?s   
are likely prev5table4  7#d7 ,accord+ to
 ! ,national ,in/itutes ( ,heal?1       
d\la-assi/$ mo!rs are f\r times less    
likely to h a l[-bir?-weight baby1 two  
times less likely to exp]i5ce a bir?    
complication involv+ !mselves or _!     
baby1 & significantly m likely to       
initiate brea/fe$+4  7#e7 ,midwife-l$   
c>e is associat$ ) co/ sav+s1 decreas$  
rates ( int]v5tion1 l[] ces>ean rates1  
l[] pret]m bir? rates1 & heal?i]        
outcomes = mo!rs & babies4  7#f7        
,midwives may practice 9 any sett+1     
includ+ ! home1 community1 hospitals1   
cl9ics1 or heal? units4  #c4 ,m$icaid   
cov]age ( s]vices provid$ by d\las &    
midwives  7a7 ,9 g5]al ,section #aije ( 
! ,social ,security ,act 7#db ,u4,s4,c4 

#acif;d7 is am5d$-- 7#a7 9 subsection   
7a7--  7,a7 9 p>agraph 7#bi71 by /rik+ &
 at ! end2  7,b7 by r$esignat+ p>agraph 
7#cj7 z p>agraph 7#ca72 &  7,c7 by      
ins]t+ aft] p>agraph 7#bi7 ! foll[+ new 
p>agraph3  7#cj7 s]vices1 includ+       
pr5atal1 deliv]y1 & po/p>tum s]vices1   
provid$ by d\las & midwives 7z ^? t]ms  
are def9$ 9 subsection 7ff77 to ! ext5t 
au?oriz$ "u ,/ate law2 &  2 &  7#b7 by  
add+ at ! end ! foll[+ new subsection3  
7ff7 ,d\las & midwives def9$ ,= purposes
 ( subsection 7a77#cj73  7#a7 ,d\las    
def9$ ,! t]m d\la means an individual   
:o-- 7,a7 is c]tifi$ by an organization1
 :i* has be5 e/abli%$ = n less ?an five 
ye>s & :i* requires ! completion (      
cont9u+ education to ma9ta9 su*         
c]tification1 to provide non-m$ical     
advice1 in=mation1 emotional support1 & 
physical com=t to an individual dur+ su*
 individual's pregnancy1 *ildbir?1 &    
po/p>tum p]iod2 &  7,b7 ma9ta9s su*     
c]tification by complet+ su* requir$    
cont9u+ education4  7#b7 ,midwives def9$

  7,a7 ,9 g5]al ,! t]m midwife means a  
c]tifi$ midwife1 c]tifi$ pr(essional    
midwife1 lic5s$ midwife1 &              
,tribal-recogniz$ midwife4  7,b7        
,c]tifi$ midwife ,= purposes (          
subp>agraph 7,a71 ! t]m c]tifi$ midwife 
means an individual :o is c]tifi$ by !  
,am]ican ,midwif]y ,c]tification ,bo>d  
to practice midwif]y4  7,c7 ,c]tifi$    
pr(essional midwife ,= purposes (       
subp>agraph 7,a71 ! t]m c]tifi$         
pr(essional midwife means an individual 
:o-- 7i7 is c]tifi$ by ! ,nor? ,am]ican 
,regi/ry ( ,midwives to practice        
midwif]y = normal1 l[-risk pregnancies &
 *ildbir?s2  7ii7 completes-- 7,i7 a    
midwif]y education program accr$it$ by !
 ,midwif]y ,education & ,accr$itation   
,c\ncil or any o!r entity recogniz$ by !
 ,dep>tm5t ( ,education2 or  7,,ii7 !   
requirem5ts to obta9 a ,midwif]y ,bridge
 ,c]tificate f ! ,nor? ,am]ican ,regi/ry
 ( ,midwives2 &  7iii7 ma9ta9s !        
c]tification describ$ 9 clause 7i7 by   
complet+ any requir$ cont9u+ education =

 su* c]tification4  7,d7 ,lic5s$ midwife
 ,= purposes ( subp>agraph 7,a71 ! t]m  
lic5s$ midwife means1 ) respect to a    
,/ate1 an individual :o is lic5s$ "u    
,/ate law to practice midwif]y4  7,e7   
,tribal-recogniz$ midwife ,= purposes ( 
subp>agraph 7,a71 ! t]m                 
,tribal-recogniz$ midwife means an      
individual :o is recogniz$ by an ,indian
 tribe 7z def9$ 9 section #d ( ! ,indian
 ,heal? ,c>e ,improvem5t ,act7 to       
practice midwif]y = su* tribe4  4  7b7  
,requir+ m&atory cov]age "u ,/ate plan  
,section #aijb7;a77#aj77;,a7 ( ! ,social
 ,security ,act 7#db ,u4,s4,c4          
#acif;a7a77#aj77;,a77 is am5d$1 9 !     
matt] prec$+ clause 7i71 by /rik+ &     
7#bi7 & ins]t+ 7#bi71 & 7#cj74  7c7     
,effective date  7#a7 ,9 g5]al ,subject 
to p>agraph 7#b71 ! am5dm5ts made by ?is
 section %all apply ) respect to m$ical 
assi/ance furni%$ on or aft] ,janu>y #a1
 #bjbj4  7#b7 ,exception = ,/ate        
legislation ,9 ! case ( a ,/ate plan "u 
title ,,xix ( ! ,social ,security ,act  

7#db ,u4,s4,c4 #acif et seq47 t !       
,secret>y ( ,heal? & ,human ,s]vices    
det]m9es requires ,/ate legislation 9   
ord] = ! respective plan to meet any    
requirem5t impos$ by am5dm5ts made by   
?is section1 ! respective plan %all n be
 reg>d$ z fail+ to comply ) !           
requirem5ts ( su* title solely on !     
basis ( its failure to meet su* an      
additional requirem5t be=e ! fir/ day ( 
! fir/ cal5d> qu>t] beg9n+ aft] ! close 
( ! fir/ regul> session ( ! ,/ate       
legislature t beg9s aft] ! date ( !     
enactm5t ( ?is ,act4 ,= purposes ( !    
previ\s s5t5ce1 9 ! case ( a ,/ate t has
 a #b-ye> legislative session1 ea* ye> (
 ! session %all be consid]$ to be a     
sep>ate regul> session ( ! ,/ate        
legislature4