CARE for Moms Act
- Sponsor
- Rep. Kelly, Robin L. [D-IL-2]
- Committees
- Ways and Means Committee (primary)
- Last action
- Nov 25, 2025
Bottom line
This bill comprehensively addresses the maternal health crisis, particularly racial disparities, through expanded healthcare access, workforce development, and public health infrastructure, funded by increased tobacco taxes.
What it actually does
The CARE for Moms Act aims to significantly reduce maternal mortality and morbidity in the United States by expanding Medicaid and CHIP coverage for oral health and extending postpartum benefits to 12 months. It establishes grant programs for perinatal quality collaboratives, doula workforce development, and rural mobile health units. The bill also mandates implicit bias training centers, extends WIC benefits, requires hospitals to notify of obstetric unit closures, and increases excise taxes on various tobacco products to fund these initiatives.
Proponents argue
Supporters argue the bill is a critical, multi-faceted approach to a national public health crisis, especially the disproportionately high maternal mortality rates among Black women. They emphasize that expanded Medicaid coverage, doula services, and rural health units will improve access to care, while implicit bias training will address systemic racism in healthcare. The tobacco tax increase provides a dedicated funding stream for these vital public health investments.
Opponents contend
Critics may argue that the extensive expansion of federal healthcare mandates and spending represents an overreach of federal power into state healthcare systems. Concerns could be raised about the economic impact of significantly increased tobacco taxes on consumers and businesses, and whether such taxes disproportionately affect lower-income populations. Some may also question the effectiveness or necessity of certain grant programs or the administrative burden they place on states and providers.
The bill is moderately long and covers diverse policy areas, requiring a dedicated reading of 30-45 minutes to grasp its full scope. Given its comprehensive nature, a thorough public review would necessitate more time than typically afforded for major legislative packages.
Section 3(a)
State-Based Perinatal Quality Collaborative Grants
This provision establishes a grant program through the CDC to fund the development and sustainability of State-based Perinatal Quality Collaboratives (PQCs). These PQCs are multidisciplinary networks aimed at improving maternal and infant health outcomes by advancing evidence-informed clinical practices, spreading best practices, and optimizing resources across various birth settings.
Supporters argue
Supporters argue that PQCs are proven mechanisms for improving maternal and infant health outcomes by standardizing best practices and fostering collaboration among healthcare providers. This funding will help scale successful models nationwide and address preventable deaths.
Critics contend
No specific opposition is typically raised against funding for perinatal quality collaboratives, as they are generally seen as beneficial for public health. Potential concerns might revolve around administrative efficiency or grant allocation fairness.
Tradeoffs
The primary tension is ensuring equitable distribution of funds and effective implementation across diverse state healthcare landscapes, as well as balancing federal oversight with state autonomy.
Section 3(b)(1)
Mandatory Oral Health Coverage in Medicaid/CHIP
This provision amends the Social Security Act to require State Medicaid and CHIP plans to cover comprehensive oral health services for pregnant and postpartum women. This includes preventive, diagnostic, periodontal, and restorative care consistent with recommendations from leading professional organizations, for the duration of pregnancy and up to one year postpartum.
Section 3(b)(2)
Extended Postpartum Medicaid/CHIP Coverage
This provision amends the Social Security Act to require states to provide 12 months of continuous Medicaid and CHIP coverage for pregnant and postpartum individuals, extending coverage beyond the current 60-day postpartum period. This ensures access to full benefits throughout the critical first year after birth.
Section 3(b)(5)
Enhanced FMAP for Postpartum Medicaid/CHIP
This provision increases the Federal Medical Assistance Percentage (FMAP) for states covering medical assistance for individuals during the 305-day period following the initial 60-day postpartum period (effectively the 12-month postpartum period). States will receive 100% FMAP for the first 20 quarters (5 years) and 90% thereafter for these extended services.
Section 3(b)(6)
Doula Services Medicaid Guidance
This provision directs the Secretary of Health and Human Services to issue guidance to states within one year on options for Medicaid coverage and payment for support services provided by doulas. This aims to encourage states to offer doula services, recognizing their proven benefits.
Section 3(b)(7)
Enhanced FMAP for Rural OB/GYN Services
This provision increases the Federal Medical Assistance Percentage (FMAP) to 90% for states for obstetric and gynecological services furnished in hospitals located in rural areas. This aims to support rural hospitals in providing these critical services.
Section 3(c)
Implicit Bias and Cultural Competency Centers
This provision establishes a program for the Secretary of HHS to award cooperative agreements for regional centers of excellence. These centers will focus on educating healthcare professionals about implicit bias, cultural competency, and respectful care practices in patient-provider interactions, particularly concerning maternal mortality and severe maternal morbidity.
Section 3(d)
WIC Postpartum Eligibility Extension
This provision amends the Child Nutrition Act of 1966 to allow states to certify postpartum women for WIC benefits for a period of 2 years, extending the current eligibility period for breastfeeding women from 1 year to 2 years postpartum, and allowing states to certify all postpartum women for 2 years.
Section 4
Doula Workforce Development Grants
This section establishes a grant program to award funds to various entities (health professions schools, community organizations, etc.) to establish or expand programs that train and diversify the doula workforce. Funds can be used for education, training, scholarships, and recruitment strategies, especially for individuals from underserved communities experiencing high rates of maternal mortality.
Section 5
Rural Mobile OB Health Unit Grants
This section establishes a pilot program to award grants to states to purchase and equip rural mobile health units. These units will provide pre-conception, pregnancy, postpartum, and obstetric emergency services in rural and underserved communities. Grants also cover training for providers and addressing social determinants of health. States receiving grants must assure no data sharing with law enforcement regarding personally identifiable information of pregnant/postpartum individuals.
Section 6
Hospital OB Unit Closure Notification
This provision amends the Social Security Act to require hospitals participating in Medicare to notify the Secretary of HHS at least 90 days prior to closing any obstetric unit. The notification must include a report analyzing the impact on the community and steps the hospital will take to alleviate service gaps.
Section 7
Federal Maternal Health Needs Report
This section mandates the Secretary of HHS to prepare and submit a report to Congress within 24 months. The report will analyze where maternal health needs are greatest in the U.S. and how federal expenditures addressed these needs from 2000-2024. It must include analysis of federal fund distribution, barriers to applying for funds, reasons for funding denials, and disaggregated data by race, ethnicity, insurance, and language.
Section 8
Tobacco Excise Tax Increases and Parity
This section significantly increases federal excise taxes on various tobacco products, including roll-your-own tobacco, pipe tobacco, smokeless tobacco (introducing a new category for discrete single-use units), small cigars, and large cigars. It also doubles the tax on small and large cigarettes. Furthermore, it clarifies the tax rate for 'other tobacco products' determined by the FDA, aiming for tax equity across all tobacco products on a 'per use' basis.
This provision establishes a 5-year maintenance of effort (MOE) requirement for states, preventing them from having eligibility standards, methodologies, or procedures for pregnant or postpartum women under Medicaid or CHIP that are more restrictive than those in effect on the date of enactment.
Section 3(b)(3)
Why it matters:Standard legislative practice to prevent states from undermining federal expansions by tightening other eligibility criteria.
Case for: Ensures that states do not roll back existing coverage or make it harder for pregnant and postpartum women to access Medicaid/CHIP, thereby preserving the intent of the bill's coverage expansions.
Case against: Some states might argue that MOE requirements limit their flexibility to manage their Medicaid programs and respond to changing fiscal conditions or population needs.
Estimated impact: Prevents potential reductions in coverage for millions of pregnant and postpartum individuals over five years.
This subsection specifies the effective dates for the Medicaid/CHIP amendments, generally one year after enactment. However, it includes an exception for states requiring state legislation, allowing them more time (until the first day of the first calendar quarter after the close of their first regular legislative session after enactment) to comply. It also allows states to elect an earlier effective date.
Section 3(b)(8)
Why it matters:Standard legislative practice to account for state legislative cycles and provide flexibility for implementation.
Case for: Provides necessary flexibility for states to adapt their laws and administrative systems to the new federal requirements, preventing disruptions in coverage or state non-compliance due to legislative timelines.
Case against: Could delay the full implementation of the expanded coverage in some states, potentially leaving some individuals without benefits for a longer period.
Estimated impact: Affects the timeline of implementation for Medicaid/CHIP expansions in states that require legislative action.
This provision mandates that the dollar amounts for tobacco excise taxes established in the bill be increased annually for inflation, starting after 2025, using the cost-of-living adjustment determined under section 1(f)(3) of the Internal Revenue Code.
Section 8(j)
Why it matters:Standard legislative practice to ensure tax rates maintain their real value over time without requiring future legislative action.
Case for: Ensures that the public health impact of tobacco taxes (by maintaining their deterrent effect) and the revenue generated for maternal health programs are not eroded by inflation over time.
Case against: Opponents of tobacco taxes might argue that automatic inflation adjustments further exacerbate the regressive nature of these taxes without requiring periodic legislative review.
Estimated impact: Ensures the long-term fiscal and public health effectiveness of the tobacco tax increases.