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Committee amends and passes S.53 to create perinatal doula certification; Medicaid coverage contingent on federal waiver
Summary
The Senate Government Operations Committee amended and reported S.53 favorably; the bill establishes perinatal doula certification and directs Medicaid to cover certified services, but state officials said federal approval and funding remain unresolved.
The Senate Government Operations Committee voted to amend and then pass S.53, legislation to establish a certification program for community-based perinatal (community-based perinatal doulas) and to direct Medicaid coverage for certified services contingent on federal approval.
At the meeting, committee members considered an amendment (draft 1.1) that added a $25,000 appropriation at the request of the Office of Disability and Rehabilitation (as described in committee discussion). The committee chair called the roll for the amendment and recorded affirmative responses from Senator Hartman, Senator Demings, Senator Douglas and Senator Lyons; the amendment carried and the bill was amended.
After the amendment, the committee debated whether the bill, without an explicit Medicaid appropriation, would achieve the policy goals. A Medicaid representative (identified in committee discussion as Alex) explained three main concerns: there is currently no appropriation in the bill to pay for Medicaid coverage; securing Medicaid coverage would require federal approval (a state plan amendment or waiver) and that OPR’s voluntary certification process must comply with federal reimbursement requirements. “Firstly, we don't have an appropriation here for Medicaid coverage, but we do have a mandate here for Medicaid coverage,” Alex told the committee. Alex further outlined timing and cost considerations and said that coverage could not begin until federal approval is obtained.
The committee also discussed estimated program costs and utilization scenarios. Committee testimony cited a proposed maximum reimbursement model of $2,100 per patient; using that model, 10% utilization would translate to roughly $425,000 and 30% utilization to about $1.3 million in annual reimbursement obligations, according to the figures provided to the committee.
Following discussion, a motion to report S.53 favorably out of committee as amended was made and seconded. Committee members recorded affirmative votes from Senator Hart, Senator Hopkins, Senator Douglas, Senator Bullock and Senator Hawkins; the motion passed and S.53 was reported favorably out of committee.
The committee and witnesses stressed that implementing Medicaid coverage requires multiple steps beyond committee passage: establishing the certification infrastructure, applying for federal approval or a state plan amendment with the Centers for Medicare & Medicaid Services, and then identifying funding in a future budget. The bill’s effective date discussed in committee appeared to be July 1, 2026, giving time for federal and budgetary steps before coverage would begin if federal approval is granted.
Votes at a glance • Amendment (draft 1.1) — recorded affirmatives: Senator Hartman (Yes); Senator Demings (Yes); Senator Douglas (Yes); Senator Lyons (Yes). Outcome: amendment adopted. • Final committee vote on S.53 (as amended) — recorded affirmatives: Senator Hart (Yes); Senator Hopkins (Yes); Senator Douglas (Yes); Senator Bullock (Yes); Senator Hawkins (Yes). Outcome: reported favorably out of committee.
The committee indicated it will continue to work with the Office of Professional Regulation and the Agency of Human Services on implementation details and on pursuing any required federal approvals before Medicaid reimbursement could begin.
