Gov. Glenn Youngkin speaks at the unveiling of a maternal hub in Petersburg on April 11, 2023. (Meghan McIntyre / Virginia Mercury)
Virginia officials say the expansion of Medicaid coverage to include doula services last year is one of several accomplishments that has made the state a leader in increasing access to maternal health resources.
Now the state’s Health Insurance Reform Commission is weighing whether this coverage should be mandated for commercial insurers as well.
In a speech during a ribbon-cutting ceremony for a new maternal hub at maternal care organization Urban Baby Beginnings in Petersburg on April 11, Gov. Glenn Youngkin said his administration is committed to improving maternal and child health outcomes in Virginia.
“Fostering maternal and infant health is one of the true cornerstones of making Virginia the best place to live and work and raise a family,” Youngkin said.
In addition to providing a wide array of resources to mothers, the maternal hub recognized Tuesday also offers state-certified doula services. Urban Baby Beginnings Executive Director Stephanie Spencer said such services are important for mothers with commercial insurance to be able to access, because doulas can help address rising maternal mortality rates in Virginia.
“If our goal is to improve outcomes across the board across the state, we have to remember that there are other people that still have a coverage gap, but they may not necessarily be on the Medicaid product,” Spencer said.
A doula is a non-medical professional who is trained to provide a broad range of support services during and after pregnancy. Several studies, including one published last December by the U.S. Department of Health and Human Services, indicate doulas positively impact maternal and infant health outcomes, especially for women of color.
Many people — “more than you would think,” Spencer said — have reached out to Urban Baby Beginnings asking if the organization accepts commercial insurance.
Virginia has already begun considering whether the state should require commercial insurance to cover the service. This session, Sen. Jennifer Boysko, D-Fairfax, and former Del. Nadarius Clark, D-Portsmouth, introduced bills making coverage mandatory. Under state law, all bills mandating health insurance benefits must first be reviewed by the Virginia Health Insurance Reform Commission.
If the body finds doula services should be a mandated benefit and legislators decide to resurrect the proposal, a bill requiring commercial insurers to offer coverage could be signed into law as early as next year, although HIRC has up to two years to complete its assessment.
Youngkin spokesperson Macaulay Porter didn’t answer a question about whether the governor supports mandated doula service coverage for commercial insurance. However, she noted in an email that “under Governor Youngkin, Virginia is leading the nation in certified doulas. As of April 7, 2023, there are 107 doulas certified in Virginia and 56 who are enrolled in Medicaid [managed care organizations].”
Representatives from insurance company Anthem Blue Cross Blue Shield who attended the Petersburg ribbon cutting did not respond to comment requests from the Mercury asking if they support mandated doula service coverage.
In Virginia, Medicaid enrollees now have doula service coverage for nine prenatal and postpartum visits after an amendment to the state’s plan went into effect last year. Each visit can last 60 minutes, except for the initial prenatal visit, which can last up to 90 minutes, and the doula can be present at delivery.
The doulas have to be state-certified, meaning they have to complete training approved by the Virginia Board of Health, as a result of legislation passed in 2020. Certified doulas are eligible to apply for reimbursement of the costs of their services through the Department of Medical Assistance Services, which oversees Virginia’s Medicaid program.
Even though commercial insurance coverage for doula services did not become mandatory this year, several other pieces of legislation aimed at providing additional support for mothers, infants and families were recently signed into law by Youngkin.
Those include bills from Del. Emily Brewer, R-Isle of Wight, and Sen. Siobhan Dunnavant, R- Henrico, requiring that in a case of child support, the responsibility for expenses incurred by a mother before and after the delivery of a child should be shared with the other parent.
Dunnavant, an OB-GYN, also passed bills requiring the Virginia Maternal Mortality Review Team to report data on maternal mortality rates every year instead of every three years and directing the Secretary of Health and Human Resources to assess how Virginia could improve perinatal and infant health. Those proposals cleared both chambers unanimously.
“This bipartisan approach that it takes to get everything done in Richmond today brought solutions to help tackle the challenges facing expectant mothers and their families, especially those that are lacking the resources to find and get the care that they need,” said Youngkin.
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