Missouri House passes Doula Reimbursement Act to support pregnant individuals

On April 17, 2025, the Missouri State Legislature introduced House Bill 1095, a significant piece of legislation aimed at enhancing maternal health support through the establishment of the "Missouri Doula Reimbursement Act." This bill seeks to address the growing need for accessible maternal care by allowing for the reimbursement of doula services under the state's Medicaid program, known as MO HealthNet.

The primary purpose of House Bill 1095 is to recognize and formalize the role of doulas—trained professionals who provide continuous physical, emotional, and informational support to pregnant individuals. The bill outlines key provisions, including the definition of doula services and the establishment of community-based networks to connect pregnant individuals with necessary resources. By facilitating access to these services, the bill aims to improve maternal health outcomes, particularly for those receiving MO HealthNet benefits.

Notably, the bill clarifies that the Show-Me Healthy Babies program, which is linked to this initiative, will not be considered an entitlement program. Instead, it will rely on federal allotments and matching state appropriations, meaning its sustainability is contingent upon federal funding and state legislative support. This aspect has sparked debate among lawmakers regarding the long-term viability of the program, especially if federal support diminishes.

Opposition to House Bill 1095 has emerged from concerns about the potential financial implications for the state budget. Critics argue that linking doula services to federal funding could create uncertainty in the program's future, particularly if appropriations are not guaranteed. Proponents, however, emphasize the importance of investing in maternal health, citing studies that demonstrate the positive impact of doula support on birth outcomes and maternal well-being.

The economic implications of this bill could be substantial. By potentially reducing complications during childbirth and improving postpartum care, the state may see a decrease in healthcare costs associated with maternal and infant health issues. Additionally, the bill could foster job growth within the doula profession and related community services.

As House Bill 1095 progresses through the legislative process, its future remains uncertain. Experts suggest that if passed, it could serve as a model for other states looking to enhance maternal health support. However, the reliance on federal funding and the ongoing debates surrounding its financial sustainability will be critical factors to monitor in the coming months. The bill's outcome could significantly influence the landscape of maternal health services in Missouri, shaping the support available to pregnant individuals and their families.