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Senate health committee advances H.611 with one‑year delay for Medicaid doula coverage
Summary
The Senate Health & Welfare committee reviewed H.611, a package of Medicaid and health‑system technical changes, and heard testimony supporting Medicaid coverage for doula services while the Department of Vermont Health Access sought a one‑year delay to submit the state‑plan amendment to CMS to allow time for rulemaking and implementation planning.
The Vermont Senate Health & Welfare Committee reviewed H.611 on March 25, hearing testimony and a section‑by‑section presentation from the Department of Vermont Health Access.
Alex McCracken, director of communications and legislative affairs for the Department of Vermont Health Access, said H.611 bundles several technical changes: it would repeal an administrative pharmacy reporting requirement; remove a recently added 340B discrimination provision; update statutory language for Medicaid and marketplace advisory committees to reflect new federal rules and a newly created beneficiary advisory committee; correct the definition of reflective plans to apply to the individual market only; allow the clinical utilization review board (CURB) to set 'a minimum of 10' members rather than exactly 10 to permit staggered terms; delete unused MAGI language in the V‑FARM statute; increase the burial‑fund exclusion cap from $10,000 to $15,000 with a Medicaid payback requirement; and, in section 8, delay the deadline to seek a Medicaid state‑plan amendment for doula services from July 2026 to July 2027.
Maria Rossi, a doula, social worker and co‑founder of the Doula Association of Vermont, testified in support of Medicaid coverage for doula care. Rossi said doulas provide non‑clinical interpersonal support before, during and after childbirth and cited a body of evidence showing reduced interventions and improved outcomes: "Over 40 years of studies show that doula care leads to a 30% reduced risk in labor inductions, a 28% reduced risk in unnecessary cesarians, a 14% reduced risk in newborn admission into the NICU," she told the committee. Rossi said DAB and the Office of Professional Regulation have worked with the department on draft regulations and supported a referral‑based approach that aligns with CMS criteria.
McCracken and Ashley Berliner, director of Medicaid policy at the Agency of Human Services, said the department supports covering doula services but asked for the additional year for planning, coordination with the Office of Professional Regulation and to reduce the risk of federal CMS scrutiny during approval of a state‑plan amendment. Berliner described the SPA as "the contract between CMS and the state" that specifies who may provide services and who is eligible; she said the department plans to begin technical work this year and submit a SPA in 2027 under the proposed schedule.
On burial funds, the department explained the $10,000 statutory exclusion dates to 2002 and the bill raises that cap to $15,000 while implementing Medicaid payback language; McCracken said the Vermont Funeral Directors Association has signaled support and the department will confirm implementation details.
Primary‑care advocates, including Nik Mullman of the Vermont Primary Care Association, signaled concern about the repeal of the 340B‑related language in section 2 and asked the committee to consider an amendment to close a loophole left from prior legislation; McCracken said the department will return to ledger counsel and the committee to address those technical issues.
No formal vote on H.611 was recorded during the hearing segment covered by this transcript. Committee members asked clarifying questions about implementation details, who may refer for doula services under the proposed rules, and the timing of the SPA process. The department said it would follow up with requested clarifications and any needed technical fixes.
Next steps: the committee signaled it would take up H.611 again, consider technical amendments and receive additional follow‑up from D.VA, OPR and stakeholders before final action.
