Kira Johnson Act
- Sponsor
- Rep. Adams, Alma S. [D-NC-12]
- Committees
- Energy and Commerce Committee (primary)
- Last action
- Mar 25, 2026
Bottom line
The Kira Johnson Act seeks to combat maternal health disparities through targeted funding for community support, mandatory anti-bias training for healthcare providers, and new compliance and reporting mechanisms within maternity care settings.
What it actually does
This bill establishes several grant programs and mandates studies aimed at reducing maternal mortality and severe maternal morbidity, particularly focusing on racial and ethnic disparities. It authorizes sustained funding for community-based organizations to advance maternal health equity, creates grants for respectful maternity care training in healthcare settings, and establishes a program for respectful maternity care compliance within hospitals. Additionally, it commissions studies by the National Academies and the Comptroller General on bias and discrimination in maternity care.
Proponents argue
Proponents argue that this bill directly addresses the urgent crisis of preventable maternal deaths and severe complications, which disproportionately affect racial and ethnic minority groups. They contend that by investing in community-based solutions, mandating respectful care training, and establishing accountability mechanisms, the bill will foster a more equitable and safer maternal healthcare system, ultimately saving lives and improving health outcomes for birthing individuals and their families.
Opponents contend
Opponents might raise concerns about the scope and cost of the federal programs, arguing that some mandates could impose undue administrative burdens on healthcare providers and institutions without guaranteed effectiveness. They may also question the efficacy of federally prescribed training programs or compliance mechanisms in fundamentally altering deeply ingrained systemic issues, suggesting that resources might be better allocated through existing state or local initiatives.
The bill is relatively short and clearly structured, making it accessible for an informed reader to evaluate its core provisions within a reasonable timeframe.
Section 2
Sustained Funding for Community-Based Organizations to Advance Maternal Health Equity
This section directs the Secretary of Health and Human Services (HHS) to award grants to eligible community-based organizations (CBOs) to establish or expand programs that improve maternal health outcomes, especially for demographic groups with high rates of maternal mortality or disparities. The bill authorizes $100,000,000 annually for fiscal years 2027 through 2031 for these grants. Special consideration is given to CBOs that are based in and serve affected communities, are led by individuals from these groups, and offer evidence-based programs addressing mental health, substance use, social determinants of health, perinatal health workers, research, group care, infant formula shortages, pregnancy loss support, and midwifery practices.
Supporters argue
Supporters argue that community-based organizations are uniquely positioned to address maternal health disparities due to their deep understanding of local needs and ability to provide culturally competent care. Direct funding to these organizations ensures that resources reach the most vulnerable populations and support innovative, evidence-based interventions that have proven effective.
Critics contend
Critics might contend that while the intent is good, a large federal grant program could lead to administrative inefficiencies, potential for fraud, or a 'one-size-fits-all' approach that may not perfectly suit diverse local needs. Concerns could also be raised about the sustainability of programs once federal funding concludes.
Tradeoffs
The bill balances the need for targeted federal investment in maternal health equity with the challenge of ensuring effective and accountable distribution of funds to a diverse array of community-based organizations. It also navigates the tension between supporting existing CBOs and fostering new initiatives.
Section 3
Respectful Maternity Care Training for All Employees in Maternity Care Settings
This section amends the Public Health Service Act to authorize HHS to award grants for programs designed to reduce and prevent bias, racism, and discrimination in maternity care settings. The grants will fund training for all employees who interact with pregnant and postpartum individuals, including front desk staff, healthcare professionals, and administrators. Programs receiving special consideration will emphasize periodic training, implicit bias, cultural humility, trauma-informed care, antiracism, and the value of diverse care teams. This section authorizes $5,000,000 annually for fiscal years 2027 through 2031.
Section 4
Study on Reducing and Preventing Bias, Racism, and Discrimination in Maternity Care Settings
This section directs the Secretary of Health and Human Services to contract with the National Academies of Sciences, Engineering, and Medicine to conduct a study. The study will focus on the design and implementation of programs aimed at reducing bias, racism, and discrimination in maternity care, and advancing respectful, culturally and linguistically congruent, trauma-informed care. The study may explore topics such as developing evaluation standards (scorecards) for these programs and determining the most effective types and frequencies of training to improve patient outcomes and experiences for racial and ethnic minority groups.
Section 5
Respectful Maternity Care Compliance Program
This section authorizes HHS to award grants to hospitals, health systems, and other maternity care settings to establish respectful maternity care compliance programs. These programs must include mechanisms for patients, families, or perinatal health workers to report instances of racism or bias, and institutional response mechanisms to follow up on reports. Grantees must also develop and publicly share a strategy to reduce bias, routinely assess its presence, collect and publicly report patient-reported experience data, and submit annual reports to the Secretary on reported cases. The Secretary is also required to establish processes for disseminating best practices, promoting coordination, and evaluating program effectiveness, and to conduct a study on strategies to address racism/bias and successful implementation of respectful care initiatives.
Section 6
GAO Report on Respectful Maternity Care Compliance Programs
This section mandates that the Comptroller General of the United States (GAO) submit an annual report to Congress, starting two years after enactment, on the establishment of respectful maternity care compliance programs. The report will assess the extent to which hospitals and other birth settings have established these programs, their impacts on maternal health outcomes and patient experiences (especially for racial and ethnic minority groups), and factors contributing to decisions not to establish such programs. It will also evaluate the sufficiency of funding and provide recommendations for expanding program establishment.
The bill defines 'maternal mortality' to include deaths occurring within a 1-year period after pregnancy, caused by pregnancy-related or childbirth complications, including suicide, overdose, or other deaths resulting from mental health or substance use disorders attributed to or aggravated by pregnancy-related or childbirth complications.
Section 7
Why it matters:Defining terms in a dedicated section is standard legislative practice to ensure clarity and consistency throughout the bill. However, the specific scope of 'maternal mortality' is critical for understanding the full reach and intent of the bill's interventions.
Case for: Supporters argue that this broad definition accurately reflects the complex and often delayed nature of maternal deaths, including those related to mental health and substance use, which are frequently overlooked in narrower definitions. This comprehensive scope ensures that interventions and data collection efforts address the full spectrum of factors contributing to maternal mortality.
Case against: No specific opposition is typically raised against a comprehensive definition of maternal mortality, as it aligns with public health goals. However, some might argue that a broader definition could make it harder to isolate and address direct medical complications versus broader societal factors, potentially diluting the focus of interventions.
Estimated impact: This definition significantly expands the scope of maternal deaths that the bill's programs and studies are intended to address, potentially increasing the number of cases and conditions considered relevant for intervention and data collection.
The bill defines 'perinatal health worker' broadly to include nonclinical health workers such as doulas, community health workers, peer supporters, lactation educators, nutritionists, childbirth educators, social workers, home visitors, patient navigators, and language interpreters.
Section 7
Why it matters:Standard legislative practice for defining terms. However, the specific inclusion of a wide range of nonclinical roles is a substantive policy choice.
Case for: Proponents argue that this broad definition acknowledges the critical role of nonclinical support in improving maternal health outcomes, especially for underserved communities. It validates and integrates these roles into the broader healthcare system, enabling grant funding to support a comprehensive, holistic approach to maternal care.
Case against: No specific opposition is typically raised against including a broad range of support roles, as it reflects an integrated care model. Some might argue about the specific qualifications or scope of practice for each role, but not their general inclusion.
Estimated impact: This definition allows federal grant funding (under Section 2) to be used to support a wide array of nonclinical maternal health services, significantly expanding the types of interventions and personnel that can be funded.
The bill defines 'racial and ethnic minority group' by cross-referencing section 1707(g)(1) of the Public Health Service Act (42 U.S.C. 300u-6(g)(1)).
Section 7
Why it matters:Standard legislative practice to avoid reprinting lengthy definitions and ensure consistency with existing law. However, it means the specific groups targeted by the bill's equity focus are not immediately apparent from the bill text itself.
Case for: Proponents argue that using an established federal definition ensures consistency across government programs and avoids creating new, potentially conflicting, definitions. It leverages existing legal frameworks for addressing health disparities.
Case against: No specific opposition is typically raised against using an existing federal definition. Some might argue that for clarity, the definition should be explicitly stated within the bill, or that the referenced definition itself might not be sufficiently comprehensive for the specific context of maternal health.
Estimated impact: This cross-reference ensures that the bill's focus on 'racial and ethnic minority groups' aligns with existing federal policy on health disparities, directing resources and interventions to the populations identified under that broader framework.