House advances bill to study Medicaid coverage and regulation of doulas

The House advanced Senate Bill 109, directing the Office of Professional Regulation to conduct a sunrise review of doula regulation and requiring the Department of Vermont Health Access to develop a methodology for estimating costs and reimbursement rates should Medicaid cover doula services.

The bill reporter, the Member from Barnet, said the measure would study whether doulas should be required to obtain registration, certification, or licensure and asked OPR to report its sunrise review to relevant House and Senate committees by January 8, 2025. The bill also tasks DVHA with a FY2026 budget explanation of the methodology and a recommendation on Medicaid coverage, including whether a state plan amendment would be necessary.

Supporters cited evidence presented to the House Health Care Committee and in written materials. The reporter quoted a paper in the Journal of Perinatal Education summarizing that "expectant mothers matched with a doula had better birth outcomes," and cited committee testimony that doula support was associated with lower rates of low birth weight and fewer cesarean deliveries. The Appropriations Committee explained there was no general fund impact, noting steps taken in the House budget to add $70,000 to support OPR workload; the Appropriations report said the appropriation would come from the OPR special fund or existing base budgets.

During questioning the Member from Berkshire asked whether testimony addressed private insurers covering doulas; the reporter said the committee did not take testimony about private insurance and that S.109 focuses on Medicaid coverage and a feasibility study.

After debate and committee reports the House ordered third reading for the bill.

The bill report and committee testimony included contributions from OPR, the Joint Fiscal Office, DVHA staff, Vermont Care Partners, Vermont Legal Aid, Washington County Mental Health Services, and the University of Vermont Medical Center. The House advanced S.109; next steps are third reading and any further floor action required before final concurrence or enactment.