Legislative committee weighs S 53 to certify doulas, flags Medicaid timing and costs

A legislative committee discussed S 53, a bill to create voluntary certification for community-based perinatal doulas and to require Medicaid reimbursement for doula services contingent on a state plan amendment, focusing on cost estimates and the time needed to implement Medicaid coverage.

The bill would add community-based perinatal doulas to Office of Professional Regulation (OPR) statutes, establish a voluntary certification with $75 initial and $120 biennial renewal fees, require background checks, set a minimum age of 18, and require OPR to appoint two certified doulas as advisors. Legislative counsel explained the certification program would begin July 1, 2026, with rulemaking completed beforehand; Medicaid reimbursement would begin July 1, 2026, or on approval of a state plan amendment (SPA), whichever is later.

Why it matters: supporters said doula services are associated in research with better birth outcomes and lower use of higher-cost interventions, and that untreated perinatal mood and anxiety disorders impose substantial costs on the state. Opponents and some staff raised concerns about obligating future budgets and the time required for a SPA and IT changes before Medicaid could reimburse doulas.

The bill and certification. James Harvey, Office of Legislative Counsel, summarized the…