Kira Johnson Act
- Sponsor
- Sen. Warnock, Raphael G. [D-GA]
- Committees
- Health, Education, Labor, and Pensions Committee (primary)
- Last action
- Mar 25, 2026
Bottom line
The Kira Johnson Act aims to reduce maternal mortality and morbidity by funding community support, mandating anti-bias training, and establishing compliance programs in maternity care settings to address systemic racism and discrimination.
What it actually does
This bill establishes several grant programs under the Department of Health and Human Services to address maternal health disparities, particularly among Black and other underserved populations. It provides funding for community-based organizations, mandates training for all employees in maternity care settings to reduce bias and discrimination, and creates respectful maternity care compliance programs within hospitals and health systems. Additionally, it commissions studies by the National Academies and the Secretary of HHS to evaluate and recommend strategies for improving maternal care equity.
Proponents argue
Proponents argue that this bill is a critical step towards addressing the severe and persistent racial disparities in maternal health outcomes, which disproportionately affect Black pregnant and postpartum individuals. They contend that by investing in community-based solutions, mandating comprehensive anti-bias training for all healthcare staff, and establishing accountability mechanisms, the bill will foster more respectful, equitable, and ultimately safer maternity care, saving lives and improving health for vulnerable populations.
Opponents contend
Opponents might contend that while the goals of improving maternal health are laudable, the bill's approach could lead to excessive federal intervention in healthcare operations and impose significant administrative burdens on hospitals and providers. Concerns could also be raised about the efficacy of mandated training programs without clear, measurable outcomes, or that the explicit focus on race could be perceived as divisive rather than promoting universal improvements in care.
The bill is relatively concise and clearly structured, allowing for a thorough understanding of 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 to award grants to eligible community-based organizations (CBOs) to establish or expand programs that improve maternal health outcomes. Special consideration is given to CBOs that are based in and serve communities with high rates of maternal mortality, are led by individuals from affected demographic groups, and offer evidence-based programs addressing mental health, substance use, social determinants of health, health literacy, perinatal worker support, research, group care, infant formula shortages, pregnancy loss support, or midwifery practices. The bill authorizes $100 million annually for fiscal years 2027 through 2031 for these grants.
Supporters argue
Supporters argue that community-based organizations are uniquely positioned to address local maternal health disparities due to their deep understanding of community needs and ability to provide culturally and linguistically congruent care. Direct funding empowers these organizations to implement effective, evidence-based interventions.
Critics contend
Critics might express concerns about the administrative overhead associated with federal grant programs for numerous CBOs, potentially leading to inefficiencies or challenges in ensuring consistent quality and accountability across a diverse range of recipients.
Tradeoffs
The provision balances the desire to empower grassroots organizations with the need for federal oversight and accountability in grant distribution and program effectiveness.
Section 3
Respectful Maternity Care Training for All Employees
This section amends the Public Health Service Act to authorize grants for programs that reduce and prevent bias, racism, and discrimination in maternity care settings. These programs aim to advance respectful, culturally and linguistically congruent, and trauma-informed care. Special consideration is given to applications that include all employees interacting with pregnant and postpartum individuals (from front desk staff to security), emphasize periodic training, address implicit bias and cultural humility, offer continuing education units, and integrate antiracism training. The bill authorizes $5 million annually for fiscal years 2027 through 2031 for these grants.
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. A report on the study's results is due to Congress within 24 months of the Act's enactment.
Section 5
Respectful Maternity Care Compliance Program
This section authorizes grants to accredited 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 for timely follow-up. Grantees must also develop and publicly share a strategy to reduce bias, routinely assess its presence, and collect/publicly report patient-reported experience data. Annual reports on reported cases and institutional changes must be submitted to the Secretary. 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, with a report to Congress.
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 the Act's enactment. The report will assess the establishment of respectful maternity care compliance programs in hospitals and other maternity care settings. It will include information on which facilities establish programs, their impacts on maternal health outcomes and patient experiences (especially for racial and ethnic minority groups), identify geographic areas or types of facilities where programs are not being established and the reasons why, and provide recommendations for expanding these programs. The report will also assess the sufficiency of funding provided for these initiatives.
Defines 'postpartum' as the 1-year period beginning on the last day of an individual's pregnancy.
Section 3(f)(1)
Why it matters:Standard legislative practice to consolidate definitions, but the specific duration of 'postpartum' has significant implications for the scope of care and support covered by the bill.
Case for: Supporters argue that extending the postpartum period to one year is crucial for addressing the full spectrum of maternal health challenges, including mental health conditions and chronic diseases, which often manifest or persist long after immediate childbirth.
Case against: No specific opposition is typically raised against this definition, as it aligns with evolving medical understanding of the postpartum period's importance.
Estimated impact: Expands the timeframe for eligible care and support under the bill's provisions, ensuring comprehensive attention to maternal well-being beyond the traditional 6-week period.
Specifies that respectful maternity care training programs should apply to 'all maternity care providers and any employees who interact with pregnant and postpartum individuals in the provider setting, including front desk employees, sonographers, schedulers, health care professionals, hospital or health system administrators, security staff, and other employees.'
Section 3(b)(1)
Why it matters:Standard legislative practice to detail criteria for grant awards, but the explicit inclusion of non-clinical staff is a deliberate and impactful policy choice.
Case for: Proponents emphasize that patient experience is shaped by every interaction within a healthcare setting, not just with doctors or nurses. Training all staff ensures a consistent, respectful, and unbiased environment from the moment a patient enters the facility.
Case against: Some might argue that training non-clinical staff on complex issues like implicit bias and trauma-informed care could be resource-intensive and potentially beyond their direct scope of influence on clinical outcomes.
Estimated impact: Significantly broadens the reach of anti-bias and respectful care training beyond traditional clinical staff, aiming for a holistic cultural shift within maternity care settings.
Includes 'coordinat[ing] mutual aid efforts during infant formula shortages, including community milk depots, donor human milk banks and exchanges, and forums for community outreach and education' as a program area for which community-based organizations can receive special consideration for grants.
Section 2(e)(2)(C)(viii)
Why it matters:It's a very specific, practical detail within a broader list of program types, reflecting a response to a particular public health challenge.
Case for: Supporters highlight that infant formula shortages can disproportionately impact vulnerable families, and community-based solutions like milk banks and mutual aid are crucial for ensuring infant nutrition and reducing stress on new parents, especially in underserved communities.
Case against: No specific opposition is typically raised against supporting infant nutrition, though some might question the federal government's role in coordinating local mutual aid efforts.
Estimated impact: Provides federal support and legitimacy for community-led initiatives addressing critical infant nutrition needs during crises, potentially strengthening local resilience.