Bill Overview
Title: Mamas First Act
Description: This bill requires state Medicaid programs to cover doula and midwife services, including prenatal, delivery, and postpartum services, in a variety of settings.
Sponsors: Sen. Warren, Elizabeth [D-MA]
Target Audience
Population: Pregnant individuals and those in the postpartum period
Estimated Size: 2000000
- The bill specifically targets services related to pregnancy, childbirth, and postpartum periods, which implies that it will primarily affect pregnant women and those who have recently given birth.
- Doula and midwife services are utilized primarily by women during pregnancy, childbirth, and postpartum periods, so the focus will be on this demographic.
- State Medicaid programs' coverage expansion suggests that women who are eligible for Medicaid or are on Medicaid during their pregnancy will be directly impacted.
Reasoning
- The primary beneficiaries of the Mamas First Act are pregnant and postpartum women on Medicaid, who currently account for a substantial portion of births in the U.S.
- Given Medicaid's role in covering nearly half of all births in the U.S., this policy will have a notable impact on women's health during and after pregnancy, particularly for low-income families.
- The budget considerations indicate that the policy will not extend to the entire population of Medicaid-eligible mothers immediately, but rather focus on those states that choose to implement or expand these services.
- The presence of doulas and midwives is expected to improve support during pregnancy and childbirth, potentially enhancing maternal health outcomes and wellbeing.
Simulated Interviews
Waitress (Houston, Texas)
Age: 28 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 10/20
Statement of Opinion:
- I think having access to a doula would really help me feel more supported during my pregnancy.
- Medicaid covering these services would really save me a lot of money and provide the help I know I need as a first-time mother.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 8 | 5 |
Cashier (Louisville, Kentucky)
Age: 23 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 3.0 years
Commonness: 8/20
Statement of Opinion:
- I really could have used a midwife with my first baby; it was really overwhelming doing it all on my own.
- I hope the program is available here—it would make such a difference.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 6 | 4 |
| Year 10 | 5 | 4 |
| Year 20 | 5 | 4 |
Freelance Writer (New York City, New York)
Age: 35 | Gender: female
Wellbeing Before Policy: 8
Duration of Impact: 0.0 years
Commonness: 7/20
Statement of Opinion:
- I'm glad more women will have access to doulas and midwives. It was invaluable for me.
- Although it won't affect me personally now, it's a progressive step towards improving maternal health.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 8 |
| Year 5 | 8 | 8 |
| Year 10 | 8 | 8 |
| Year 20 | 8 | 8 |
Student (Detroit, Michigan)
Age: 19 | Gender: female
Wellbeing Before Policy: 3
Duration of Impact: 8.0 years
Commonness: 6/20
Statement of Opinion:
- It's so scary being young and pregnant. I'm really relieved if I can get more support without worrying about extra costs.
- Midwives could make the experience feel less overwhelming and more personal.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 3 |
| Year 2 | 6 | 3 |
| Year 3 | 7 | 4 |
| Year 5 | 7 | 4 |
| Year 10 | 6 | 4 |
| Year 20 | 6 | 4 |
Registered Nurse (Dallas, Texas)
Age: 45 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 0.0 years
Commonness: 7/20
Statement of Opinion:
- This is a much-needed policy; it will fill a gap in maternal care for those who need it the most.
- I support the policy wholeheartedly and believe it will lead to better health outcomes.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 7 | 7 |
| Year 20 | 7 | 7 |
Software Developer (Seattle, Washington)
Age: 29 | Gender: female
Wellbeing Before Policy: 8
Duration of Impact: 0.0 years
Commonness: 5/20
Statement of Opinion:
- I won't be directly impacted as I plan to not rely on Medicaid, but it's great this is being offered.
- I believe services like these should be universally accessible to improve healthcare equality.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 8 |
| Year 5 | 8 | 8 |
| Year 10 | 8 | 8 |
| Year 20 | 8 | 8 |
Artist (Santa Fe, New Mexico)
Age: 38 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 0.0 years
Commonness: 4/20
Statement of Opinion:
- Having Medicaid cover midwives for others is fantastic; it was a huge help for me.
- Hopefully, it will encourage more women to consider midwife services.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 7 | 7 |
| Year 20 | 7 | 7 |
Homemaker (Miami, Florida)
Age: 31 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 4.0 years
Commonness: 6/20
Statement of Opinion:
- I wish this was available back when I had my first child, but having it now will be a huge relief.
- Having more control and support this pregnancy will be life-changing.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 7 | 6 |
| Year 20 | 6 | 6 |
Teacher (Portland, Oregon)
Age: 26 | Gender: other
Wellbeing Before Policy: 5
Duration of Impact: 6.0 years
Commonness: 4/20
Statement of Opinion:
- This policy feels inclusive and needed. A doula could provide a unique perspective and help cater to my specific needs.
- Medicaid covering this would greatly reduce stress during my pregnancy.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 5 |
Unemployed (Birmingham, Alabama)
Age: 32 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 2.0 years
Commonness: 8/20
Statement of Opinion:
- Had a tough time during my first pregnancy, a doula would have made things easier.
- If this is implemented soon, it will definitely improve my wellbeing.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 5 | 4 |
| Year 3 | 5 | 4 |
| Year 5 | 4 | 4 |
| Year 10 | 4 | 4 |
| Year 20 | 4 | 4 |
Cost Estimates
Year 1: $500000000 (Low: $400000000, High: $600000000)
Year 2: $525000000 (Low: $420000000, High: $630000000)
Year 3: $551250000 (Low: $441000000, High: $661500000)
Year 5: $575000000 (Low: $460000000, High: $690000000)
Year 10: $600000000 (Low: $480000000, High: $720000000)
Year 100: $750000000 (Low: $600000000, High: $900000000)
Key Considerations
- The policy improves access to crucial healthcare services, which could lead to better health outcomes for new and expecting mothers.
- The cost implications for state Medicaid programs could vary significantly depending on the current level of doula and midwife service utilization.
- Long-term healthcare savings might be achieved if the policy helps reduce complications related to childbirth, although initial spending will increase.