• That's "a lot of progress" in a few years, says Amy Chen, senior attorney at the National Health Law Program.

Zoom in: While Georgia has taken steps related to doulas, it doesn't have a concrete Medicaid coverage plan yet.

• This year, Georgia lawmakers introduced a bill that would create a pilot program for Medicaid coverage of doula care.
• Advocacy groups, including the Healthy Mothers, Healthy Babies Coalition, have been pushing for doula Medicaid reimbursement in the state.

Yes, but: Expanding coverage could create a catch-22.

• The more doulas get folded into insurance systems, the more regulated they become. Their effectiveness, however, may stem precisely from being unregulated and fully answerable to patients, says Nicole Sessions, a doula and maternal mental health researcher in Atlanta.
• "The insurance model isn't quite savvy enough to hold the nuances of the profession just yet," she says, citing limits insurers may place on billable postpartum hours.

• Reimbursement maximums vary widely — from less than $800 to more than $3,000. Experienced doulas may not sign on if rates fall below their typical charges.

The big picture: Sessions worries that doula care is becoming a temporary fix — absorbing pressure that should be driving deeper changes to the obstetric system.

What we're watching: Whether "in process" states follow through or quietly stall, as Montana already has amid the Trump administration's cuts to Medicaid.