For seven years, the Mamas First Act has been introduced, refined, and reintroduced in Congress.
What it has not done is become law.
The legislation was first introduced in the House in 2019 as a proposal to expand Medicaid coverage for care provided by doulas and midwives. Since then, lawmakers have brought it back in new Congresses, expanded its scope and adjusted its language.
The latest version—H.R. 9712 in the House and S. 4986 in the Senate—is the broadest version yet. It would require Medicaid coverage for prenatal, delivery, and postpartum care provided by doulas, midwives, Tribal midwives, and lactation support providers, while also prohibiting cost-sharing for those covered services.
And for Black mothers and families, the stakes are especially high.
Black women continue to face disproportionate risks of pregnancy-related death and serious complications, while long-standing inequities in access to quality, culturally responsive care remain a major concern. The Mamas First Act is built around one central idea: access to maternal support should not depend on whether a family can afford to pay a doula, midwife, or lactation provider out of pocket.
So, what exactly would the bill do, and where does it stand now?
The Mamas First Act is federal legislation that would amend Medicaid law to require coverage for certain maternal health services.
The current legislation exists as companion bills:
The two current bills contain identical legislative language.
If passed, the legislation would require state Medicaid programs to cover prenatal, delivery, and postpartum care provided in a culturally congruent manner by:
The bill also recognizes that maternal care does not happen in just one place. Covered services could be provided in homes, communities, hospitals, birth centers, clinics, and health units, as well as through telehealth where permitted under state law.
The current version goes significantly beyond earlier versions of the Mamas First Act: it explicitly adds lactation support providers to the list of maternal health professionals whose services would be covered.
That matters because postpartum care does not end when a baby is delivered.
For many new mothers, breastfeeding and lactation challenges can require specialized support—support that may not be affordable or easily accessible without insurance coverage.
The current bill would also prohibit Medicaid cost-sharing for the covered maternal health services, meaning the legislation is designed to address not only whether these services are technically covered, but whether financial barriers could still stand in the way of accessing them.
The original Mamas First Act, H.R. 2751, was introduced by Rep. Gwen Moore on May 15, 2019.
Its core goal was straightforward: require Medicaid coverage for services provided by doulas and midwives.
Over time, the legislation became more specific.
The 2022 versions added a stronger focus on culturally congruent care, established more detailed provider standards, and explicitly recognized care provided across settings including homes, communities, hospitals, birth centers, and clinics, as well as telehealth where allowed.
By 2024, lawmakers had again reintroduced the legislation. The House and Senate versions shared the same overall goal but differed in some of their provider qualification language.
The current 2026 version brings the House and Senate back into alignment with identical bill text while expanding the legislation to include lactation support providers and protections against cost-sharing.
In other words, the bill has not simply been copied and pasted every two years.
It has evolved. It just hasn’t crossed the finish line.
The legislation is particularly relevant to Black maternal health because Black women continue to experience major disparities in maternal outcomes.
The current sponsors and supporters explicitly frame the bill as part of a broader effort to address racial disparities in maternal mortality and improve access to trusted, community-based maternal care. In announcing the 2026 reintroduction, congressional supporters pointed to the disproportionate impact of the maternal mortality crisis on Black, Brown, and Indigenous mothers.
The bill’s emphasis on culturally congruent care is also significant. The legislation specifically requires covered maternal care to be provided in a manner that aligns with a patient’s preferred cultural values, beliefs, worldview, language, and practices.
Access to care is not simply about getting an appointment. It can also involve whether patients feel heard, respected, and understood.
Doulas, midwives, and other community-based maternal health providers can offer support that extends beyond traditional clinical appointments, including education, advocacy, emotional support, and continuity of care.
The Mamas First Act does not claim that expanding access to these providers would solve the Black maternal health crisis on its own.
But it would attempt to remove one major barrier: whether Medicaid will pay for that care.
If the Mamas First Act becomes law, eligible Medicaid recipients could gain more consistent access to maternal support that many families currently have to pay for out of pocket or may not be able to access at all.
For Black mothers, that could mean greater access to services from doulas, midwives, Tribal midwives, and lactation support providers throughout pregnancy, childbirth, and the postpartum period.
The bill’s emphasis on culturally congruent care could also matter. The legislation defines care as maternity care provided in agreement with a patient’s preferred cultural values, beliefs, worldview, language, and practices.
For families, the proposed Medicaid coverage and cost-sharing protections could help reduce financial barriers to receiving that support.
Passage would not, by itself, solve the Black maternal health crisis. But it could change who has access to additional forms of maternal care and support—and whether the cost of that care remains a barrier.
The House version, H.R. 9712, was introduced by Rep. Gwen Moore of Wisconsin.
The Senate version, S. 4986, was introduced by Sen. Elizabeth Warren of Massachusetts.
The 2026 reintroduction was also led by Sen. Cory Booker and Reps. Debbie Dingell, Alma Adams, Lauren Underwood, and Ayanna Pressley.
The current legislation also has additional congressional cosponsors, including Sens. Alex Padilla, Bernie Sanders, Martin Heinrich, Richard Blumenthal, and Tammy Duckworth, as well as Reps. Eleanor Holmes Norton, Ted Lieu, Al Green, Adelita Grijalva, and Jan Schakowsky.
The current legislation has support from maternal health, reproductive justice, and advocacy organizations.
Organizations supporting the legislation include:
The list reflects support across maternal health, reproductive justice, birth equity, and health policy organizations.
As of August 2026, both versions of the Mamas First Act are still at the beginning of the legislative process.
H.R. 9712 was introduced in the House on July 15, 2026, and referred to the House Committee on Energy and Commerce. Its Senate companion, S. 4986, was introduced the same day and referred to the Senate Finance Committee.
At the time of publication, neither bill had advanced to a committee hearing, markup, or floor vote.
That distinction matters because this is where the bill has found itself before.
The Mamas First Act was originally introduced in 2019 and has been reintroduced in subsequent Congresses without, but has not become law.
Seven years later, the legislation is broader. The need remains urgent. But Congress still has to act.
The next meaningful milestone would be movement in committee, such as a hearing, markup, or other action that advances either bill.
If the legislation moves forward, key developments to watch include additional congressional support, committee action, a vote in either chamber, or progress by its companion bill.
For now, readers can follow the legislation through its official congressional pages:
Members of the public can also contact their representatives and senators to ask whether they support the legislation.
The Mamas First Act, currently introduced as H.R. 9712 in the House and S. 4986 in the Senate.
Rep. Gwen Moore leads the House bill, while Sen. Elizabeth Warren leads the Senate bill.
Other congressional supporters involved in the legislation include Sen. Cory Booker and Reps. Debbie Dingell, Alma Adams, Lauren Underwood and Ayanna Pressley.
The original Mamas First Act was introduced on May 15, 2019.
The current House and Senate versions were introduced on July 15, 2026.
The legislation would require Medicaid coverage for culturally congruent prenatal, delivery, and postpartum care provided by doulas, midwives, Tribal midwives, and lactation support providers.
It would also prohibit cost-sharing for those covered services.
The bill aims to improve access to affordable, culturally congruent maternal care and reduce financial barriers to services that can support mothers before, during, and after childbirth.
Supporters include Black Mamas Matter Alliance, HealthConnect One, National Health Law Program, In Our Own Voice, Families USA, National Partnership for Women & Families, Futures Without Violence, and other maternal health and birth equity organizations.
The bills must move through their respective congressional committees before advancing toward a vote. The next major development to watch is whether either committee takes action.
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