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Representative Bosley proposes Medicaid reimbursement for doula services to address maternal and infant mortality
Summary
Representative LaKesha Bosley presented House Bill 1095 to codify Medicaid reimbursement for certified doula services (prenatal, childbirth, postpartum and community navigation); supporters said evidence links doula care to lower cesarean and preterm-birth rates and improved breastfeeding and mental-health outcomes.
Representative LaKesha Bosley said House Bill 1095 — described as the “Missouri Doula Reimbursement Act” in her presentation — would add doula services to MoHealthNet-covered services, reimbursing certified doulas for prenatal and postpartum visits, lactation consultation and community navigation. She told the committee the goal is to reduce Missouri’s maternal and infant mortality rates and racial disparities and to align statutory authority with a prior state plan amendment (SPA) for doula coverage.
Bosley said evidence supports doula care as a targeted, evidence-based intervention that can lower cesarean rates, reduce preterm birth and improve breastfeeding initiation and postpartum mental health. She noted roughly 80 percent of maternal deaths in Missouri are considered preventable and stressed the policy’s potential to improve outcomes and equity.
Hospital and provider groups, including SSM Health and the American College of Obstetricians and Gynecologists, supported the bill on the record and said doulas operate alongside clinicians rather than replacing clinical care. Justin Alterman of SSM Health and Sarah Schleier for organizational supporters emphasized that the MoHealthNet SPA already includes doula services and that codifying the coverage in statute protects continuity of services across administrations. Sponsor and witnesses indicated that certified doulas would enroll as MoHealthNet providers, meet training and liability requirements and that program details could mirror the SPA.
Committee members asked about fiscal impacts and implementation. Sponsors and several witnesses noted the SPA already authorized coverage and that the committee packet included the SPA bulletin; Justin Alterman explained that the hearing transcript shows a “0 fiscal note” because MoHealthNet already offers the service under the state plan. Lawmakers asked about oversight and how providers would be certified and enrolled; witnesses said certification lists and MoHealthNet enrollment requirements would be used.
Why it matters: Supporters framed the bill as a practical, evidence-based way to reduce preventable maternal deaths and racial disparities by expanding nonclinical support that improves adherence to prenatal care and postpartum follow-up.
What’s next: Supporters asked committee members to advance the bill; no committee vote is recorded in the transcript.
