Montana Senate approves range of bills after floor debate on Medicaid coverage for doulas

The Montana Senate advanced a package of bills Tuesday and narrowly approved a measure to allow Medicaid reimbursement for state‑certified doulas after a robust floor debate.

Senators voted 30–20 to pass Senate Bill 319, which creates voluntary certification and regulation for doulas and allows the Department of Public Health and Human Services to provide Medicaid coverage for State‑certified doula services. Sponsor Senator Janet Newman said the program is small in cost and aimed at improving maternal outcomes; opponents raised concerns about Medicaid spending priorities.

Why it matters: The doula proposal would create a voluntary licensing pathway and a route for Medicaid reimbursement for certified doulas. Proponents argued the change could reduce postpartum mental‑health issues and improve access to birth support for low‑income women; opponents called the service nonessential for Medicaid and cautioned about expanding benefits without broader budgeting discussions.

Senate Bill 319 (doula certification and Medicaid coverage): Senator Newman, sponsor, told the Senate the bill was amended to change certain wording and that the certification component would distinguish paid, accountable providers from informal support. Majority Leader McGillivray opposed expanding Medicaid coverage for the service, saying the state must prioritize core services. "This bill is asking Medicaid to cover, what I consider a nonessential service," McGillivray said, adding, "I've been a doula 3 times. We have 3 children and I was a doula in all 3 of those births." Newman replied the statutory change involves about "$120,000" in fiscal exposure but argued certification would allow reimbursement only for licensed providers and could produce savings in other health outcomes.

Other debated bills and outcomes

- Senate Bill 237 (property tax review by the Revenue Interim Committee) — Sponsor Senator John Fern described the bill as placing "more responsibilities with the revenue interim committee" to study whether to revise property‑tax rates and produce recommendations to the next Legislature. Fern said Montana currently has multiple tax classes and the committee work would make tax changes more proactive. The Senate passed the bill on second reading with a vote recorded as 47–2.

- Senate Bill 343 (coal severance tax distribution) — Sponsor Senator Fern told colleagues the bill would transfer excess coal severance collections to the coal severance tax permanent fund (the trust) after existing non‑trust allocations are met, with an effective allocation change after 07/01/2027. He said increasing the trust corpus would support infrastructure and other long‑term needs; he noted Montana's current trust corpus as about $1,300,000,000 during remarks. The bill passed on second reading.

- Senate Bill 409 (Department of Commerce and lodging tax uses) — Sponsor Senator Zolka said the bill simplifies distribution buckets and directs 2.5 percent of certain lodging revenues to an emergency lodging recovery fund for victims of domestic violence or human trafficking. The Senate passed the bill on second reading, 37–13.

Votes at a glance (selected bills recorded on the floor or in committee that were reported to the Senate and acted on Tuesday): - House Bill 53 (troop labor projects) — Passed the Senate, 47–3 (third reading). - House Bill 77 (child abuse/neglect investigations procedures) — Passed the Senate, 50–0 (third reading). - House Bill 88 (automatic return of certain unclaimed property) — Passed the Senate, 50–0 (third reading). - House Bill 91 (electronic correspondence election with Department of Revenue) — Passed the Senate, 49–1 (third reading). - House Bill 120 (commercial property assessed clean energy laws) — Passed the Senate, 44–6 (third reading). - House Bill 150 (concurrence) — Committee concurrence recommended and recorded in committee 45–5. - House Bill 164 (unclaimed property revisions) — Committee concurrence recommended and recorded in committee 49–5. - House Bill 165 (vehicle title affidavit; notarization requirement) — Committee concurrence recorded 39–11 on second reading. - House Bill 235 (voluntary suspension/cancellation of motor‑vehicle registration) — Concurred, 50–0 on second reading.

What the floor did not do: The Senate considered but rejected a motion to take Senate Bill 189 from the Senate Tax table (a separate property‑tax rates bill); that motion failed 22–28.

Process notes and next steps

Most bills referenced above moved through the chamber on either third reading (final passage of House bills on the Senate floor) or second reading (Senate bills and house amendments returning from committee). Several items reported out of committee were adopted without extended floor debate; bills that passed second reading remain subject to further procedural steps depending on their origin (house vs. senate) and conference actions.

The Legislature will continue committee hearings and floor sessions; some bills that advanced Tuesday will require additional steps before becoming law, including possible free‑conference committee work on bills where the two houses differ.