BILL ANALYSIS

H.B. 1201

By: Manuel

Human Services

Committee Report (Unamended)

BACKGROUND AND PURPOSE

The Texas Maternal Mortality and Morbidity Review Committee makes recommendations to

improve maternal health outcomes, and one such recommendation involved increasing access

to doula support throughout a woman's pregnancy. Doulas are trained professionals who advise,

inform, and oversee the emotional and physical needs of the mother and have been shown to

improve birth outcomes, reduce maternal stress, and lower the likelihood of

complications during pregnancy, labor, and the postpartum period. H.B. 1201 seeks to

improve maternal health outcomes by establishing a pilot program under Medicaid to

provide reimbursement for doula services that targets counties with high maternal and infant

mortality rates and evaluates the impact of doula services on maternal health outcomes.

CRIMINAL JUSTICE IMPACT

It is the committee's opinion that this bill does not expressly create a criminal offense, increase

the punishment for an existing criminal offense or category of offenses, or change the

eligibility of a person for community supervision, parole, or mandatory supervision.

RULEMAKING AUTHORITY

It is the committee's opinion that rulemaking authority is expressly granted to the executive

commissioner of the Health and Human Services Commission in SECTION 1 of this bill.

ANALYSIS

H.B. 1201 amends the Human Resources Code to require the Health and Human

Services Commission (HHSC) to establish a pilot program to provide Medicaid

reimbursement for doula services provided by a doula, other than services for which a

qualifying doula may enroll as a provider and receive reimbursement under the Medicaid

program. The bill requires the executive commissioner of HHSC, by rule and in consultation

with the Perinatal Advisory Council, to determine the qualifications necessary for an

individual to be considered a doula and the doula services to be covered under the pilot

program. The bill requires HHSC to prescribe eligibility requirements for participation in the

program. The bill defines "doula" as a nonmedical birthing coach who provides doula services

and meets the prescribed qualifications and "doula services" as nonmedical childbirth

education, coaching, and support services, including emotional and physical support

provided during pregnancy, labor, delivery, and the postpartum period, or provided

intermittently during pregnancy and the postpartum period.

H.B. 1201 requires HHSC, not later than September 1, 2026, to implement the pilot program

in the most populous county in Texas and in the county with the greatest maternal health

support needs, as determined by the county's maternal and infant mortality rates and the

number of births in the county by Medicaid recipients. The bill requires HHSC, not later than

September 1, 2027,

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and not later than September 1 of each subsequent year during the operation of the program, to

prepare and publish on its website a report evaluating the costs and impact of the program. Not

later than September 1, 2030, HHSC must prepare and submit to the legislature a written report

that summarizes the results of the program, includes feedback from participating doulas and

Medicaid recipients who received doula services under the program, and includes a

recommendation on whether the program should be continued, expanded, or terminated. The

pilot program terminates and the bill's provisions expire September 1, 2031.

If before implementing any provision of the bill a state agency determines that a waiver or

authorization from a federal agency is necessary for implementation of that provision, the

agency affected by the provision must request the waiver or authorization and may delay

implementing that provision until the waiver or authorization is granted.

EFFECTIVE DATE

September 1, 2025.