,i  #aah? ,,congress  #b;d ,session  ,h4
 ,r4 #hcag  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,may #h1 #bjbd,ms4    
,moore ( ,wiscons9 7= h]self1 ,ms4      
,und]wood1 ,ms4 ,adams1 ,ms4 ,pressley1 
& ,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 
#bf4f dea?s p] #ajj1jjj live bir?s =    
,:ite wom51 #fi4i dea?s p] #ajj1jjj live
 bir?s = ,black wom51 #di4b dea?s =     
,am]ican ,indian & ,alaskan ,native     
wom51 & #bh dea?s p] #ajj1jjj live bir?s
 = ,hispanic wom54 ,:ile mat]nal        
mortality disp>ately impacts ,black 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 ,f\r out ( five ( ^!     
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   
bir? c5t]s1 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$-- 7#a7 9    
subsection 7a7-- 7,a7 9 p>agraph 7#cj71 
by /rik+ & at ! end2  7,b7 by r$esignat+
 p>agraph 7#ca7 z p>agraph 7#cb72 &     
7,c7 by ins]t+ aft] p>agraph 7#cj7 !    
foll[+ new p>agraph3  7#ca7 s]vices &   
c>e1 includ+ pr5atal1 deliv]y1 &        
po/p>tum c>e1 t is provid$ 9 a          
culturally congru5t mann] 7z def9$ 9    
subsection 7kk77 by d\las1 midwives1 &  
tribal midwives 7z ^? t]ms are def9$ 9  
subsection 7jj771 t is provid$ 9 ! home1
 community1 a hospital1 bir? c5t]1      
cl9ic1 heal? unit1 or is furni%$ via    
teleheal? to ! ext5t au?oriz$ "u ,/ate  
law2 &  2 &  7#b7 by add+ at ! end !    
foll[+3  7jj7 ,d\las1 midwives1 & tribal
 midwife def9$ ,= purposes ( subsection 
7a77#ca73 7#a7 ,d\las def9$ ,! t]m d\la 
means an individual :o-- 7,a7 has       
complet$ #fj h\rs ( f\ndational tra9+2  
7,b7 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$ical advice1 in=mation1  
emotional support1 & physical com=t to  
an individual dur+ su* individual's     
pregnancy1 *ildbir?1 & po/p>tum p]iod2 &
  7,c7 ma9ta9s su* c]tification by      
complet+ su* requir$ cont9u+ education4 
7#b7 ,midwives def9$ ,! t]m midwife     
means a midwife :o meets at a m9imum !  
int]national def9ition ( ! midwife &    
global /&>ds = midwif]y education z     
e/abli%$ by ! ,int]national ,conf$]ation
 ( ,midwives4  7#c7 ,tribal midwife     
def9$ ,! t]m tribal midwife means an    
individual :o is recogniz$ by an ,indian
 tribe 7z def9$ 9 section #d ( ! ,indian
 ,heal? ,c>e ,improvem5t ,act 7#be      
,u4,s4,c4 #afjc77 to practice midwif]y =
 su* tribe4  7kk7 ,culturally congru5t  
c>e def9$ ,= purposes ( subsection      
7a77#ca71 ! t]m culturally congru5t c>e1
 ) respect to mat]nity c>e1 means c>e t 
is provid$ 9 agreem5t ) ! pref]r$       
cultural values1 beliefs1 worldview1    
language1 & practices ( ! heal? c>e     
consum] & o!r /akehold]s4  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#cj7 & ins]t+ 7#cj71 & 7#ca74  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
 #bjbb4  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