Senate Health Committee adopts substitute requiring postpartum-depression screening materials and referrals

The Senate Health Committee on a voice and roll call adopted a substitute to SB 191 that directs the Alabama Department of Public Health to develop and make available educational materials about postpartum depression on the ADPH website and requires physicians to assess mothers for postpartum depression and refer them for treatment when appropriate. The committee recorded the substitute as adopted by a roll call recorded in the transcript as "11 a 0 and 8."

The sponsor, Senator Figures, told the committee the substitute also removes a Medicaid “two-step” requirement and that Medicaid agreed to cover appropriate drugs without that delay; the sponsor said that change went into effect March 1. "Sometimes you don't even know what you're going through after you have a baby," Senator Figures said, arguing the bill will help connect mothers to therapy or medication as doctors deem medically appropriate. The sponsor also thanked Commissioner Azar for working with lawmakers on the Medicaid change.

Senator Stutz said he would vote no, arguing the measure improperly legislates routine clinical practice and could steer care toward an expensive new drug. "I don't think this ought to be a legislative issue," Stutz said, adding he supported screening but objected to a statutory mandate. Stutz also warned that a newly marketed drug with a labeled indication for postpartum depression could cost about $16,000 for a two-week course and said blanket screening can produce false positives. "Two weeks ago...of the 8 postpartum patients that I rounded on, 2 of them scored higher than the cutoff on the screening test. I had sat down in the room and talked to both of them. Neither 1 of them had any signs or symptoms of postpartum depression," Stutz said, using that example to caution against legislating screening protocols.

Senator Figures responded by recounting personal experience and saying not all clinicians ask about postpartum depression; she said stakeholders, including the state medical association, had vetted the language and that the bill does not name any drug or require a specific medication.

The substitute passed in committee and will proceed through the Senate process; the transcript does not specify further floor scheduling or final enactment steps.

Votes at a glance: the committee recorded the substitute as adopted with the roll call cited in the transcript as "11 a 0 and 8."