Health & Welfare committee advances strike-all amendment to S 18 after debate over Medicaid coverage for birthing centers

The Health & Welfare committee on Feb. 28, 2025, voted to approve a strike‑all amendment to S 18, advancing the bill to the next legislative steps after committee discussion about whether independent birthing centers should be required to accept Medicaid.

Committee members and outside witnesses debated whether requiring Medicaid acceptance for birthing centers would set a precedent different from other private providers. A committee participant said there is non‑discrimination language in statute governing non‑emergency walk‑in centers that “says they shall not discriminate against any patient or prospective patient on the basis of insurance status or type of health coverage.” That comment was offered during committee consideration as part of arguments that the current statutory framework may already prohibit excluding Medicaid patients.

David Green of VAWS told the committee that in addition to what the bill calls “dish payments” to subsidize hospitals serving Medicaid patients, hospitals also receive facility fees that act as a subsidy for underpaid services; Green said the bill’s inclusion of facility fees is consequential for how Medicaid care is financed.

Committee members noted that the bill will need additional legislative steps after the committee, including potential review by appropriations because the measure contemplates Medicaid coverage. One committee member said the bill was created in the House and will return there for further consideration.

The committee proceeded with a strike‑all amendment (draft 2.1) to S 18. During the roll call on the amendment, members recorded these verbal responses: Senator Hartley, Yes; Senator Cummings, Yes; Senator Douglas, Yes; Senator Gulick, Yes; Senator Lyden, No; Senator Galipi, Yes. The motion carried and the committee chair indicated the measure will be placed on future committee and floor paths for further consideration.

The transcript does not record the full text of the bill as considered in committee in the portions provided, and details such as the precise statutory cross‑references or the full scope of Medicaid coverage required for birthing centers were not included in the recorded excerpts.

Committee members said they expect further debate on funding and subsidy issues (including the referenced facility fees and “dish payments”) in later committee stops and on the floor.

The committee did not take final action on any appropriation; members noted that because the bill contemplates Medicaid coverage it may be routed to appropriations for financial review before final passage.