What if everyone had access to a doula, no matter their income? In this episode, Dr. Dekker talks with Amy Chen, Senior Attorney at the National Health Law Program (NHeLP), about the growing movement to make doula care accessible through Medicaid and insurance coverage.

Amy shares how her personal birth experiences inspired her work advocating for Medicaid reimbursement for doulas and explains how more than 20 states (and counting) are now implementing or expanding coverage. They also unpack the biggest challenges and successes so far, from sustainable reimbursement rates and certification requirements to how doulas can navigate the Medicaid billing process.

(03:17) How Amy's birth experiences led her to advocate for Medicaid coverage of doula care

(06:54) The national shift toward Medicaid coverage for doulas after 2016 and early state pilots

(11:50) How 23 states plus D.C. have implemented Medicaid doula benefits and what comes next

(15:46) Lessons from California's rollout: raising reimbursement from $450 to $3,200 through advocacy

(20:57) Why equitable reimbursement matters for sustaining the doula workforce

(25:52) How families can find out if doula care is covered through Medicaid, private insurance, or employers

(29:53) TRICARE's pilot program for military families and expansion to overseas bases

(31:42) The challenges doulas face with Medicaid billing and how "doula hubs" help streamline the process

(36:49) How upcoming federal Medicaid cuts could threaten maternal health gains

(45:28) New 2024 research showing doula care cuts cesarean rates in half and lowers preterm births

(48:12) Closing thoughts and key resources for doulas, advocates, and policymakers

Resources

NHeLP Doula Medicaid Project: https://healthlaw.org/doulamedicaidproject/

Best Practices for Medicaid Coverage of Doula Care (2025): https://healthlaw.org/doulamedicaidproject/bestpractices/

NHeLP Doula Medicaid Project State Tracker Chart:

https://tinyurl.com/NHeLPStateTracker

CA Department of Health Care Services Doula Benefit Implementation Report:

https://www.dhcs.ca.gov/provgovpart/Documents/Doula-Benefit-Report.pdf

Private Insurance Coverage of Doula Care: Spring 2025 State of the States:

https://healthlaw.org/private-insurance-coverage-of-doula-care-spring-2024-state-of-the-states/

A Cost-Benefit Analysis of Doula Care from a Public Health Framework:

https://healthlaw.org/resource/a-cost-benefit-analysis-of-doula-care-from-a-public-health-framework/

For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram and YouTube! Ready to learn more? Grab an EBB Podcast Listening Guide or read Dr. Dekker's book, "Babies Are Not Pizzas: They're Born, Not Delivered!" If you want to get involved at EBB, join our Professional membership (scholarship options available) and get on the wait list for our EBB Instructor program. Find an EBB Instructor here, and click here to learn more about the EBB Childbirth Class.

EBB 377 - Medicaid Coverage for Doula Care with Amy Chen, Senior Attorney at the National Health Law Program

Evidence Based Birth®

EBB 377 - Medicaid Coverage for Doula Care with Amy Chen, Senior Attorney at the National Health Law Program