Vermont enacted legislation last session to begin the process of enabling Vermont families covered by Medicaid to have access to doula services. Doula support is an evidence-based policy that improves outcomes for babies and their families and promotes safer, less expensive births. Doula support is also correlated with improved infant-parent bonding and less postpartum depression and anxiety throughout the perinatal period, and increases equity in our community. This legislation, Act 50 (S.53), instructs the the Office of Professional Regulation (OPR) to create a voluntary certification process for community-based perinatal doulas and requires the Department of Vermont Health Access (DVHA) to begin the process of making a formal request to the federal government to include doula services during the prenatal and postpartum periods as well as during labor and delivery in the State Medicaid Plan.

The Alliance supports the efforts of the Doula Association of Vermont to ensure that OPR and DVHA implement Act 50 as directed by the Legislature.

Lead Organization: Doula Association of Vermont

Data and Talking Points

• About 40% of all births in Vermont are covered under Medicaid
• In Vermont, in 2021, there were 2,021 Medicaid births, about 38% of total births in the state.
• Doulas offer non-clinical, non-medical, human-to-human support. Doula care is emotional support.
• Studies show that doula care leads to a 30% reduced risk of labor induction, a 28% reduced risk of cesarean section, and a 14% reduced risk of a newborn admission to the NICU.

Result: Regulatory Progress

Pre-session goal: Ensure that OPR and DVHA implement Act 50 as directed by the Legislature.

As introduced, H.611, a DVHA/Medicaid technical amendments bill, included language allowing a two-year extension to the Act 50/ requirement that Dept. of VT Health Access (DVHA) apply for a State Plan amendment that would give the needed federal approval for the Vermont Medicaid program to provide reimbursement for Medicaid beneficiaries who opt for doula services.

The House version of the bill provided a one-year extension. The Senate concurred with that language and further amended the bill to align the doula certification process timeline administered by the Office of Professional Regulation (OPR). This version of the bill was passed by both chambers. Advocates also worked with regulators to ensure necessary steps are being taken to support implementation of Medicaid coverage. With the passage of H. 611 and regulatory work in process, doula services will potentially be available for Medicaid beneficiaries on July 1, 2027, pending federal approval.