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Committee considers bill to create doula oversight, allow Medicaid coverage for doula care
Summary
Senate Bill 319 would establish a doula oversight program within the Department of Labor and Industry and allow Montana Medicaid to cover doula services; sponsors and health advocates emphasized potential maternal‑health and cost‑savings benefits while an opponent raised concerns about licensure and government oversight of home births.
Senator Cora Neumann opened the hearing on Senate Bill 319, which would create an oversight program for doulas in the Department of Labor and Industry (DLI) and allow Montana Medicaid to cover doula care without requiring private insurers to follow.
Neumann told the committee that Montana has birth‑related health issues at a rate 35 percent higher than the U.S. average and described the bill as a low‑cost intervention. She summarized a DPHHS estimate that if 6 percent of an anticipated 4,750 births access doula care in fiscal year 2027, approximately 285 Medicaid‑covered births would receive services. Based on DPHHS numbers cited in committee, the total estimated cost for FY 2027 is $4,456,000 for the covered births with a state general‑fund share of about $117,000; Neumann reported a per‑birth cost of about $413.
Proponents included Stephanie Morton, executive director of Healthy Mothers Healthy Babies and convenor of the Montana Doula Collaborative, who said the state has a growing doula workforce and that a needs analysis identified roughly 300 potential licensees and ongoing training. Morton and other supporters emphasized studies associating doula care with reductions in cesarean and preterm births and with improved postpartum mental‑health outcomes; Morton cited cost estimates for perinatal mental‑health conditions in Montana.
An opponent, Jessica Kuykendall, described herself as a children’s health advocate and said she opposed state oversight and licensing of doulas, arguing that many doulas operate as private mentors and that government oversight could be intrusive for families choosing natural births.
DPHHS provided an informational witness (the Medicaid chief financial manager) to explain fiscal assumptions. Committee members asked about provider counts, how many births doulas currently attend, FMAP treatment for services provided by federally qualified health centers and tribal providers, and outstanding technical issues related to licensure versus certification and to DLI authority. Sponsor and proponents said they were continuing to negotiate technical language with DLI and expect to resolve outstanding implementation questions.
Neumann closed by characterizing the bill as a “small investment with a very high return,” reiterating maternal‑health statistics and asking the committee to support the bill. The transcript records the hearing and discussion but no committee vote.
