CARE for Moms Act
- Sponsor
- Sen. Durbin, Richard J. [D-IL]
- Committees
- Finance Committee (primary)
- Last action
- Sep 24, 2026
Bottom line
This bill seeks to address the rising maternal mortality crisis, especially racial disparities, through a multi-pronged approach of expanded healthcare access, workforce development, and dedicated funding from 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 access to maternal health services, particularly for underserved populations. It establishes grant programs for perinatal quality collaboratives, doula workforce development, and rural mobile health units, mandates extended Medicaid and CHIP coverage for postpartum women and oral health services, and increases excise taxes on tobacco products to fund these initiatives.
Proponents argue
Supporters argue that the bill comprehensively tackles the urgent maternal health crisis, particularly the disproportionately high rates among Black, Indigenous, and other minority women, by expanding critical services like oral health and doula care, extending postpartum Medicaid coverage, and investing in rural access. They emphasize that the tobacco tax increases provide a dedicated, health-related funding stream for these vital public health initiatives.
Opponents contend
Critics might argue that the bill imposes significant new federal mandates on states regarding Medicaid/CHIP coverage and could be seen as an overreach into state healthcare administration. Concerns might also be raised about the economic impact of increased tobacco taxes on consumers, particularly those with lower incomes, and whether such taxes are the most appropriate or stable funding mechanism for long-term health programs.
The bill is moderately complex due to its multiple sections, including detailed amendments to the Social Security Act and Internal Revenue Code. An informed reader would need adequate time to understand its full scope.
Section 3(a)
Funding for State-Based Perinatal Quality Collaboratives Development and Sustainability
This provision directs the Secretary of Health and Human Services, through the CDC, to establish a grant program to support the development and sustainability of perinatal quality collaboratives in states and territories. These collaboratives are multidisciplinary networks aimed at improving maternal and infant health outcomes by advancing evidence-informed clinical practices and sharing best practices among hospitals and clinical teams.
Supporters argue
Supporters argue that these collaboratives are proven mechanisms for improving maternal and infant health outcomes by standardizing best practices and facilitating rapid data response, as highlighted by the success in California.
Critics contend
No specific opposition is typically raised against funding for quality improvement collaboratives, though some might question the federal role versus state responsibility or the efficiency of grant distribution.
Tradeoffs
Balancing federal oversight with state autonomy in healthcare quality improvement.
Section 3(b)(1)
Mandatory Medicaid/CHIP Oral Health Coverage for Pregnant and Postpartum Women
This provision amends the Social Security Act to mandate that State Medicaid and CHIP plans cover comprehensive oral health services for women during pregnancy and for one year postpartum. These services must include preventive, diagnostic, periodontal, and restorative care consistent with professional recommendations.
Section 3(b)(2)
Mandatory 12-Month Continuous Medicaid/CHIP Postpartum 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 for a full year after pregnancy.
Section 3(b)(5) & (7)
Increased Federal Matching Funds (FMAP) for Extended Postpartum and Rural Obstetric Services
This provision significantly increases the Federal Medical Assistance Percentage (FMAP) for states. For the first 20 quarters (5 years), states will receive 100% FMAP for medical assistance provided to postpartum individuals during the extended 305-day period (after the initial 60 days). Thereafter, it drops to 90%. Additionally, states will receive 90% FMAP for obstetric and gynecological services furnished in rural hospitals, starting from the bill's enactment.
Section 3(c)
Regional Centers of Excellence Addressing Implicit Bias and Cultural Competency Education
This provision directs the Secretary of HHS to establish regional centers of excellence through cooperative agreements with eligible entities (like health systems, medical schools, community health centers). These centers will focus on educating healthcare professionals about implicit bias, cultural competency, and respectful care practices to improve patient-provider interactions, especially for minority populations.
Section 3(d)
Expansion of WIC Eligibility for Postpartum Women
This provision amends the Child Nutrition Act of 1966 to allow states to certify postpartum women for the WIC program for a period of 2 years, extending the current eligibility period. It also clarifies that breastfeeding women can be certified for 2 years postpartum.
Section 4
Full-Spectrum Doula Workforce Grant Program
This section establishes a grant program to fund eligible entities (health professions schools, community-based organizations, etc.) to create or expand programs for educating and training full-spectrum doulas. The goal is to grow and diversify the doula workforce, particularly in underserved communities, and includes scholarships for students agreeing to work in these areas.
Section 5
Grants for Rural Obstetric Mobile Health Units
This section establishes a 5-year pilot program to award grants to states for purchasing and equipping rural mobile health units. These units will provide pre-conception, pregnancy, postpartum, and obstetric emergency services in rural and underserved communities, including training providers and addressing social determinants of health. A key condition is that states cannot share personally identifiable information with law enforcement.
Section 6
Requiring Notification of Impending Hospital Obstetric Unit Closure
This provision amends the Social Security Act to require hospitals to notify the Secretary of HHS at least 90 days prior to closing any obstetric unit. This notification must include a report analyzing the impact on the community and steps the hospital will take to identify alternative providers to fill service gaps.
Section 7
Report on Maternal Health Needs and Federal Expenditures
This section mandates the Secretary of HHS to prepare and submit a report to Congress within two years of enactment. The report will analyze where maternal health needs are greatest in the U.S., how federal funds for maternal health were distributed from 2000-2024, and barriers to applying for/receiving federal funds. Data must be disaggregated by race, ethnicity, insurance status, and language.
Section 8
Increasing Excise Taxes on Tobacco Products
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 and introduces an inflation adjustment for all tobacco tax rates. Furthermore, it clarifies the definition of "tobacco products" to include any product determined by the FDA to be a tobacco product, with a tax rate equivalent to cigarettes on a per-use basis.
As a condition for receiving grants for rural obstetric mobile health units, states must assure the Secretary that they will not share any personally identifiable information regarding pregnant or postpartum individuals collected under the grant with Federal or State law enforcement.
Section 5(b)
Why it matters:This is likely a deliberate inclusion to protect vulnerable populations and encourage trust in healthcare services, especially given concerns about criminalization of pregnancy outcomes. Its placement as a grant condition is a common legislative technique to ensure compliance.
Case for: Supporters argue this is essential to build trust with patients, particularly those in marginalized communities or those with substance use disorders, ensuring they seek care without fear of legal repercussions, which is vital for improving maternal health outcomes.
Case against: Some might argue that in specific, rare circumstances, law enforcement access to certain data might be necessary for public safety or criminal investigations, though this is a highly contentious area.
Estimated impact: Significant for patient privacy and trust in healthcare, potentially increasing utilization of mobile health units by vulnerable populations.
Section 8(l) specifies varying effective dates for the tobacco tax increases: generally after the last day of the month of enactment, but 6 months after enactment for discrete single-use units, large cigars, and processed tobacco. Section 8(k) imposes "floor stocks taxes" on tobacco products removed before the tax increase date but held for sale on that date, with a $1,000 credit per person.
Section 8(k) and 8(l)
Why it matters:Standard practice for tax legislation to include detailed effective dates and floor stocks provisions to manage the transition to new tax rates and prevent stockpiling.
Case for: Proponents argue that floor stocks taxes are necessary to prevent manufacturers and distributors from stockpiling products at the lower tax rate before the effective date, thereby undermining the revenue generation and public health goals of the tax increase. Varying effective dates allow industries to adjust.
Case against: The tobacco industry might argue that floor stocks taxes create an additional administrative burden and financial strain, especially for smaller businesses, and that the varying effective dates add complexity.
Estimated impact: Ensures immediate revenue generation and prevents market manipulation, while the $1,000 credit offers minor relief to small businesses.