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Kentucky senators advance plan to expand Medicaid coverage of midwife services

A pregnant person stands with their hands resting on their exposed belly.
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The Kentucky Legislature approved a law in 2019 that arranged for the licensure of certified professional midwives. Now a new proposal addresses a related issue with insurance coverage.

A new legislative proposal would require Kentucky Medicaid to cover certain midwife services. It just cleared its first hurdle.

The Senate Committee on Families and Children unanimously voted Tuesday to advance a bill that would make midwife services more accessible to many patients in Kentucky.

Licensed certified professional midwives offer prenatal, postpartum and labor and delivery services to pregnant Kentuckians.

“Often this care is offered in a smaller home setting that has relieved mom and newborn from the exhaustion and the challenge of travel back and forth for office visits,” said Sen. Shelley Funke Frommeyer, an Alexandria Republican who is the bill’s lead sponsor.

However, the state’s Medicaid program currently is not required to cover various services provided by licensed certified professional midwives.

Senate Bill 89 would change that.

Mary Kathryn DeLodder, of the Kentucky Birth Coalition, told the Senate committee that licensed certified professional midwives already attend a majority of planned home births in the commonwealth.

She said most home births attended by licensed certified professional midwives can’t be covered by Medicaid. That puts many patients with Medicaid insurance coverage in a tough spot.

As a result, some patients:

  • Arrange to give birth in a hospital even though they’d prefer to do so at home.
  • Make financial sacrifices to pay for the midwife’s services.
  • Give birth at home without a trained provider present.

“While not everyone will choose a home birth, we believe that all maternity care options should be available to all healthy women,” she said. “Choices in childbirth should not be limited to those who have the ability to pay out of pocket."

DeLodder said the Kentucky Legislature approved a law in 2019 that arranged for the licensure of certified professional midwives. Right now, she said 32 people hold that license, with quite a few students on track to join them.

“These are not laypersons, but trained professionals who hold a national midwifery certification as well as a license in our state,” she noted.

Morgan is LPM's health reporter. Email Morgan at mwatkins@lpm.org.