House Introduces Bipartisan BABIES Act


Earlier this week, Representatives Katherine Clark (D-MA) and Buddy Carter (R-GA) introduced bipartisan legislation to expand access to freestanding birth centers for women with low-risk pregnancies (i.e., uncomplicated singleton term pregnancies with a vertex presentation with an expected uncomplicated birth). The Birth Access Benefiting Improved Essential Facility Services (BABIES) Act requires the Secretary of Health and Human Services (HHS) to establish a demonstration program with the Medicaid program to develop and advance innovative payment models for freestanding birth centers. In order to participate in the demonstration a freestanding birth center must be accredited and licensed by the state to provide prenatal, labor and delivery, postpartum, newborn care and other ambulatory services. Additionally, a freestanding birth center must employ or have care delivery arrangements with both a physician and a midwife or midwives that meet or exceed the education and training standards of the International Confederation of Midwives licensed to practice in the state or jurisdiction of the birth center. The legislation would provide planning grants to states to establish a prospective payment system for making payments for care rendered by freestanding birth centers participating in the demonstration, including partial facility payments, facility payments for observation short stays, payments for nitrous oxide and hydrotherapy costs, payments for all health professionals involved in the delivery of care, payments for partial prenatal and postpartum care episodes, and payment for prenatal care only with planned delivery in the hospital.

ACNM is a proud endorser of the BABIES Act, as it builds upon the data gleaned from the Strong Start for Mothers and Newborns initiative, an effort by the Centers for Medicare & Medicaid Services (CMS) aimed at reducing preterm births and improving outcomes for newborns and pregnant women. Under the Enhanced Prenatal Care at Birth Centers Strong Start approach, CMS found that midwifery led care in freestanding birth centers resulted in lower rates of preterm birth, lower rates of low birthweight, fewer C-sections, more weekend deliveries and more VBACs, in addition to cost savings to the Medicaid program of $2,010 per mother-infant dyad. Passage of the BABIES Act would be a step toward providing better access to midwives and birth centers for those receiving benefits under the Medicaid program.

ACNM encourages members to reach out to their House member to help build congressional support for this important legislation. Please visit our online advocacy center to send a letter encouraging your House member to cosponsor this important legislation by clicking here:


  1. This is great but we need national legislation to enforce standardized education and appropriate licensure for all midwives that practice in the country to ensure safe maternity care practices for mothers and babies

  2. Many birthing centers have difficulty getting proper reimbursement. CPM’s do not have to have a physician co-sign with the application process. Last time I looked at the process, I was required to have a physician sign the paper work. I am not sure this is actually going to get women to a midwife. I turn away all Medicaid participants and request cash from them because of the difficulty of a free standing birth center/ CNM and horrible reimbursement.