Wellness Brief
11 hours ago - Wellness Brief
Where doulas are covered by Medicaid
Add Axios as your preferred source to
see more of our stories on Google.
More than half of U.S. states now reimburse for doula care under Medicaid — but Texas isn't among those states.
The latest: The Texas Legislature passed a maternal health care bill in 2025, but it doesn't have a concrete Medicaid coverage plan.
- The Texas Doula Association, an advocacy group, says on its website, "At this time, TDA is not confident that access to Doula care will be a priority" in the wake of Medicaid cuts.
By the numbers: 28 states and D.C. are actively reimbursing, according to the National Health Law Program. Before 2020, only Oregon and Minnesota did.
- For the rest of the country, that's "a lot of progress" in a few years, says Amy Chen, senior attorney at the National Health Law Program.
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.