MOMMIES Act
- Sponsor
- Rep. Pressley, Ayanna [D-MA-7]
- Committees
- Energy and Commerce Committee (primary)
- Last action
- Jul 21, 2026
Bottom line
This bill seeks to improve maternal and infant health outcomes and reduce disparities by expanding and strengthening health care access and services for low-income mothers through Medicaid and CHIP.
What it actually does
The bill, titled the "MOMMIES Act," aims to significantly enhance Medicaid and CHIP benefits for low-income pregnant and postpartum individuals. It extends continuous coverage to one year postpartum, mandates full benefits including oral health services, establishes a maternity care home demonstration project, and increases Medicaid payment rates for primary care services and providers, including certain advanced practice clinicians and midwives. The bill also includes maintenance of effort provisions for states and provides 100% federal matching funds for new expenditures attributable to its requirements.
Proponents argue
Proponents argue that extending continuous postpartum coverage and mandating comprehensive benefits, including oral health, is crucial for addressing the maternal mortality crisis, particularly among underserved populations. They contend that the maternity care home model will provide coordinated, culturally sensitive care, and increased primary care payment rates will incentivize providers to serve Medicaid beneficiaries, ultimately leading to better health equity and outcomes for mothers and infants.
Opponents contend
Potential opponents might raise concerns about the significant federal spending implications of expanding Medicaid and CHIP benefits and increasing FMAP to 100% for additional expenditures. They may also question the administrative burden on states and healthcare providers to implement new coverage requirements, establish demonstration projects, and adjust payment methodologies, potentially leading to increased taxes or budget strain.
The bill is moderately detailed, requiring a careful read to understand the specific amendments to the Social Security Act and the scope of the demonstration project.
Section 2(a)
Extension of Postpartum Coverage
This provision amends titles XIX (Medicaid) and XXI (CHIP) of the Social Security Act to extend continuous eligibility for pregnant and postpartum individuals from the current 60-day period to a 1-year period beginning on the last day of pregnancy. States also have the option to elect an even longer period.
Supporters argue
Supporters argue that extending postpartum coverage is vital to address the leading causes of maternal mortality and morbidity, which often occur in the period beyond 60 days postpartum. It ensures continuity of care for physical and mental health needs.
Critics contend
Some might argue that this expansion places an undue financial burden on states, even with enhanced federal matching, and could lead to increased federal healthcare spending without clear evidence of proportional health improvements.
Tradeoffs
Balances the goal of improving maternal health outcomes against potential increases in state and federal healthcare expenditures.
Section 2(b)
Mandating Full Medicaid Benefits
This section amends Section 1902(e)(5) of the Social Security Act to require that any individual eligible for Medicaid while pregnant continues to receive full medical assistance, equivalent to that available for an individual in a mandatory eligibility group, through the end of the 1-year postpartum period (or longer if a state elects). This ensures comprehensive care, not just pregnancy-related services.
Section 2(c)
Mandating Oral Health Services
This provision amends Section 1905(a) of the Social Security Act to add oral health services as a required benefit for pregnant and postpartum individuals under Medicaid. It defines these services to include preventive, diagnostic, periodontal, and restorative care consistent with recommendations from leading pediatric dentistry and obstetrics/gynecology organizations. A conforming amendment is made for CHIP.
Section 2(d)
State Maintenance of Effort
This section establishes a maintenance of effort (MOE) requirement for states. For Medicaid, states cannot impose more restrictive eligibility standards or reduce the scope of medical assistance for low-income pregnant individuals from the levels in effect on the date of enactment, for calendar quarters beginning on or after enactment and before January 1, 2027. For CHIP, a similar MOE applies for targeted low-income pregnant individuals from January 1, 2027, to January 1, 2031. Failure to comply results in no federal payment.
Section 2(e)
100% Federal Match for New Expenditures
This provision amends Section 1905(b) of the Social Security Act to provide a 100% Federal Medical Assistance Percentage (FMAP) for additional amounts expended by states for medical assistance attributable to the new requirements imposed by the MOMMIES Act. This enhanced FMAP applies for calendar quarters beginning on or after January 1, 2027.
Section 3
Maternity Care Home Demonstration Project
This section establishes a 5-year demonstration project, administered by the Secretary of HHS, to provide grants to at least 10 states (including at least one territory) to implement or expand a maternity care home model. The goal is to improve maternity and infant care outcomes, birth equity, and health equity for underserved populations by providing coordinated, evidence-based, and culturally appropriate care. Eligible entities include birth centers, FQHCs, rural health clinics, and Indian health facilities. States must partner with these entities to provide comprehensive services, risk assessments, care coordination, and essential support services.
Section 4
Enhanced Medicaid Payment for Primary Care and Maternity Providers
This section reestablishes and expands the Medicaid payment rate floor for primary care services. It requires states to pay providers for primary care services at a rate not less than 100% of the Medicare Part B rate (or 2009 Medicare rate if higher) for services furnished during a specified period. Crucially, it expands the definition of "provider" to include obstetrician-gynecologists, advanced practice clinicians (like nurse practitioners, physician assistants, certified nurse-midwives, and certified professional midwives), rural health clinics, FQHCs, and other health clinics, especially in rural or underserved areas, with potential for a 25% increase. It also ensures managed care entities comply with these payment rates.
Section 5
Doula Services Report and Guidance
This section requires MACPAC to publish a report within one year on the coverage of doula services under State Medicaid programs, including existing coverage, barriers, strategies, and recommendations. Following this, CMS must issue guidance to states on increasing access to doula services, including options for coverage, best practices for reimbursement (ensuring living wages), and strategies for increasing access, particularly for community-based doulas.
Section 6
Telehealth for Maternity Care GAO Report
This section directs the Comptroller General (GAO) to submit a report within one year on State Medicaid programs' use of telehealth to increase access to maternity care. The report must cover the number of states using telehealth, common characteristics and differences in approaches, health outcomes, services provided, devices used, quality of care, patient satisfaction, impact on spending, and effectiveness during COVID-19. It also requires an analysis of barriers and recommendations.
Amends section 1902(e)(6) of the Social Security Act to change the continuous Medicaid coverage period for pregnant individuals from a "60-day period" to a "1-year period" postpartum, with an option for states to elect a longer period.
Section 2(a)(1)(A)(i)
Why it matters:This is standard legislative practice for amending existing statutes. The change in duration is explicit, but its full impact requires understanding the original text.
Case for: Supporters argue this seemingly small change is a monumental step towards addressing the maternal mortality crisis by ensuring continuous care during a critical and vulnerable period for mothers.
Case against: Opponents might argue that extending this period significantly increases federal and state financial obligations, and the long-term cost implications need careful scrutiny.
Estimated impact: Substantially increases the duration of Medicaid coverage for millions of postpartum individuals, leading to significant federal and state expenditure increases.
This amendment redefines the scope of medical assistance for pregnant and postpartum individuals, requiring it to include "all items and services covered under the State plan (or waiver) that are not less in amount, duration, or scope... to the medical assistance available for an individual described in subsection (a)(10)(A)(i)."
Section 2(b)(1)
Why it matters:This is standard legislative drafting for ensuring comprehensive benefits by referencing existing, well-defined benefit packages within Medicaid law.
Case for: Proponents argue this ensures postpartum individuals receive truly comprehensive care, not just limited pregnancy-related services, which is essential for addressing the full spectrum of postpartum health needs.
Case against: Critics might contend that this broad mandate could significantly increase state costs beyond what is immediately apparent, as states would be required to cover a wider array of services for a longer period.
Estimated impact: Expands the range of services covered for postpartum individuals, leading to increased utilization and costs for states and the federal government.
This section significantly expands the definition of "provider" eligible for enhanced Medicaid payment rates for primary care services to include obstetrician-gynecologists, advanced practice clinicians (nurse practitioners, physician assistants, certified nurse-midwives, certified professional midwives), rural health clinics, FQHCs, and other health clinics.
Section 4(b)(2)
Why it matters:This is typical for definitional sections in complex legislation, where a key policy change is implemented by modifying the scope of a defined term.
Case for: Supporters argue that including these specific providers, especially those focused on women's health and those in underserved areas, is critical to improving access to maternity and primary care for Medicaid beneficiaries.
Case against: Critics might argue that expanding the list of eligible providers for enhanced rates could lead to a broader and more significant increase in federal and state spending than initially estimated, without necessarily guaranteeing improved quality of care.
Estimated impact: Broadens the pool of providers receiving higher Medicaid reimbursement, increasing federal and state expenditures for primary and maternity care services.