In 2021, California included in the state budget funding to add full spectrum doula care as a new covered benefit for all pregnant and postpartum people in Medi-Cal. The programs also emphasized the importance of a sustainable reimbursement rate in ensuring program sustainability and workforce retention. Here in California, the doula Medi-Cal benefit has a tremendous potential to save the lives of pregnant and birthing people and infants in California, given that 40% of births in the state are financed by Medi-Cal. Now, she applauds Californias turnaround. KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. How To Get Medical Insurance to Pay For Doula Services More info. Some doulas point to local government and private insurance programs that pay even more. Minnesota has been offering a doula benefit since 2014. This report summarizes in-depth interviews with 100 Black Californians and 18 focus groups, as well as a statewide survey of 3,325 adult Black Californians. The same year, Governor Gavin Newsom signed SB 65, the California Momnibus, which included additional support for implementation of the doula Medi-Cal benefit. Tamara Robertson is examined by midwife Kimberly Durdin during her 26-week checkup at Kindred Space LA on Sept. 30, 2020, in Los Angeles. The services were free to patients, and participating doulas were paid a maximum of $1,000 per birth in Riverside County to $3,000 in Alameda County. The amount originally set for doula reimbursement in the Governors 2021-2022 budget was roughly $450 per birth. Doulas act as coaches, guiding families through pregnancy and advocating for them in the hospital during labor and delivery, as well as through the postpartum period. The provision of full spectrum doula care to Medi-Cal enrollees will help to save the lives of pregnant and birthing people and infants in California, especially those racial and ethnic groups experiencing the highest rate of health disparities. Gestational diabetes influences diabetes risk and blood sugar control. Some states that took this route included Maryland ( SB 163 - died in committee) and Washington, D.C. ( B 24-26 ). It is likely that the role of doulas in connecting their clients with resources such as food, housing, transportation, and mental health support, among others, will be even more critical for doulas serving Medi-Cal enrollees, who may have a greater need for additional support, coordination of care, and connection to resources. Some states introduced bills that do not immediately cover doula care for Medicaid beneficiaries, but instead establish pilot programs in the state. Specifically, they have recommended a minimum rate of $1000 for presence at the birth, $100 for each prenatal or postpartum visit, and $250 for doula support for an abortion or miscarriage. From 2014 to 2020, the state paid for doulas in roughly 850 births (this in a state where 20,000 people a year give birth while enrolled in Medicaid). Lawmakers in several states are looking to follow Rhode Islands example through either requiring or encouraging private plans to cover doula care. This approach is inherently flawed as it fails to take into consideration key differences between doulas and medical providers such as physicians or midwives. And you might be less likely to need pain medicines. Doula services have been associated with better birth outcomes, such as lower rates of cesarean sections, more breastfeeding, and fewer babies born underweight. "Because the rate for perinatal visits is so low, it doesnt make a huge difference overall in terms of state expenditures," Gmez said. Cost varies from state to state and most people pay out of pocket for a doula. Six more are in the process of following this trend, including. Once the governor signs the new spending plan, Medi-Cal coverage for doula services will take effect in January 2023 and cost $10.8 million a year. "I love that they have so many visits paid for," Nolan said. For Black mothers, the maternal death rate is more than double the average and nearly three times higher than the rate for white women. By clicking "Allow All" you agree to the storing of cookies on your device to enhance site navigation, Doulas insurance - cost and types of policies - SBCoverage.com Use of Wegovy for weight loss has risen to around 135,000 new prescriptions per week in May from 45,000 in the last week of January, according to Barclays Research, and is widely expected to . on this website is designed to support, not to replace the relationship They can also help you feel supported after your baby is born. Nonetheless, the original SB 65 language pertaining to doula care is still relevant to highlight for other states seeking to introduce bills for doula care coverage. We do have some hopeful examples in other states. In general, insurance does not typically cover doula services. @RachelHBluth, By Rachel Bluth During negotiations, doulas sought as much as $3,600 for each pregnancy and for maternal support through a year after birth. This is why some employerssuch as CVS Health and Microsoftare already offering doula coverage to their employees; more employers should follow suit. Total of $2,000 to $2,3000. This bill sought to establish a doula care commission that provides recommendations on the implementation and evaluation of doula care reimbursement; recommendations for required doula competencies, standards of proof, or demonstrations of competency; recommendations for a diverse doula and doula trainer workforce development strategy; and approves reimbursement rates for doula services, among others. But that rate was so low that few doulas were willing to accept Medicaid patients. This includes a maximum of $2000 for a doula to provide support sessions (including prenatal, postpartum, and check-in sessions) as well as support through a major perinatal experience (including labor and delivery, abortion, or pregnancy loss). KHN is the publisher of California Healthline. But at least one insurer told me that they are already working to connect families with doulas.. Next chapter in Americas aging boom? Couples searching for doulas can find one on DONA International's website. On average, nationwide, premium home insurance rates increased roughly 21% in that time frame. This means individuals are now guaranteed doula coverage if they purchase a plan through the Rhode Island health insurance exchange or receive coverage through a Rhode Island employer with less than fifty employees (excluding self-insured plans). One Year After President Bidens LGBTQI+ Equity EO, NHeLPs Automated Decision-Making Principles in Medicaid Continuous Coverage Unwinding, Proposed Medicaid Work Requirements are Another Dangerous Attack on Sexual and Reproductive Health and Justice. If a story is labeled All Rights Reserved, we cannot grant permission to republish that item. New coverage for doula services - Blue Cross Blue Shield of Rhode Island Marianna Dale, a reporter for KPCC who covers early childhood, says state governments are realizing the economic advantages to providing this type of support. We recognize the value of the work that doulas provide to mothers and infants, specifically, the intensity of the services and length of time doulas spend, the states Department of Health Care Services, which administers Medi-Cal, wrote in a May 13 email to a group of doulas and researchers advising the department on the new benefit. Unlike obstetricians, who see many patients in a day, most doulas accept only a few clients a month. *Kate Rohde was an intern at NHeLP in spring 2023. The structure of Californias benefit is still being determined. . $450? For more information about the National Health Law Programs work on Medicaid coverage for doula care in California and nationally, please see ourDoula Medicaid Projectpage. This story also ran on Los Angeles Times. For some, that still wont be enough in a high cost-of-living state with caseloads limited by the unpredictability and time-consuming nature of doula work. A growing number of lawmakers and advocates are now looking to expand doula coverage in private plans. Medi-Cal will cover doulas at more than twice California's initial A recent study found that maternal and infant health mortality rates remain disproportionately high even among wealthy Black families. Chantel Runnels serves clients in the Inland Empire and may drive more than 100 miles round trip for patients. rbluth@kff.org, Some city health departments, like Contra Costa Health Services, offer programs to people who want to be trained as a doula. Lawmakers and advocates hope that by providing doulas to the states poorest and most vulnerable women, California will help address racial disparities, improve birth outcomes, and diversify and expand its healthcare workforce. In response, Gov. Some advocates welcomed the new benefit in Medi-Cal, the state's Medicaid health insurance program, as a step toward professionalizing this group of nonmedical birth workers. KFF is an endowed nonprofit organization providing information on health issues to the nation. Now, she applauds California's turnaround. Medi-Cal: Doulas - Training as Medi-Cal Providers The downside, however, is that some doulas may not earn the full rate if their clients dont use all their allotted visits before or after birth. Gavin Newsom last month increased his proposal to $1,154, far higher than in most other states. They say better pay may encourage more people to become doulas. We also see similarly high rates of Black infant mortality. Other advocates, however, called it a partial victory, saying that the rate is still too low for the amount of time and work it takes to ensure healthy deliveries. They also support mothers during birth to make sure their wishes are being respected by the hospital. "I think that's really good.". Others included a commitment to including doula Medicaid coverage in their State Plan Amendment (SPAs). But Oregons $350 maximum payment is too low to attract enough doulas, said Amy Chen, a senior attorney with the National Health Law Program who studies doula Medicaid benefits across states. Tags: Breastfeeding, Childbirth, Health Care, Health Insurance, Hospital, Labor, Medicaid, Mortality, Pregnancy. Most doulas in her area charge non-Medicaid patients $800 to $1,500 per birth. They spent more than a year kind of setting it up with stakeholders, and they outlined everything from what they're going to do, to how much they're going to get paid. Some advocates . California will cover doula services for low-income residents at more than twice the states initial proposed rate under a spending plan lawmakers passed this week. Advocates hope that adding doulas to Medi-Cals covered services could help lower maternal mortality rates, especially for Black mothers, who die because of childbirth at a rate nearly three times that of white mothers. Because they are not medical professionals, they are not considered essential care. Doulas also told the state they want to bill separately for labor and prenatal and postnatal visits, instead of receiving a bundled flat rate. Gavin Newsom last month increased his proposal to $1,154, far higher than in most other states. It will also allow doulas to effectively support their clients, help to facilitate a stable doula workforce, and ultimately support a birth justice oriented framework in California. Minnesota, which already includes Medicaid coverage for doula care in their State Plan Amendment (SPA), introduced SF 1475. Moreover, doula care is cost-effective, meaning insurance plans can cover doula care without incurring extra expenses. For more information about the National Health Law Programs work on Medicaid coverage for doula care, please see ourDoula Medicaid Projectpage. A whopping 90% of homes in California aren't covered by earthquake insurance, according to Glenn Pomeroy, CEO of the California Earthquake Authority, a nonprofit quake insurer established by the .