H.R. 4150 — Advancing Maternal Health Equity Under Medicaid Act

This section establishes a 90% federal medical assistance percentage (FMAP) for state Medicaid expenditures on maternal health care services (i.e., prenatal, labor and delivery, and postpartum services furnished by maternity care providers or perinatal health workers, including telehealth, home visiting, and mental or behavioral health care) that exceed the corresponding quarterly baseline from the four-quarter period ending December 31, 2019, for calendar quarters beginning on or after January 1 of the year beginning one year after enactment. (Thus, the FMAP applies only to spending growth above the 2019 baseline.) As conditions for these payments, states must (1) use them to supplement, not supplant, state funds expended on such services as of January 1, 2023; and (2) direct them to activities increasing capacity, efficiency, and quality of such services. The section defines maternity care providers (e.g., physicians, midwives meeting International Confederation of Midwives standards, nurse practitioners) and perinatal health workers (e.g., doulas, community health workers, lactation counselors), and specifies postpartum period as one year following pregnancy end. (As background, Medicaid's regular FMAP reimburses states for a share—typically 50% to 83% based on per capita income—of expenditures for medical services to low-income individuals, including pregnant women; this provision incentivizes expanded maternal health investments amid U.S. maternal mortality concerns.)