# The BABIES Act: Making Birth Centers More Accessible Through Medicaid

The BABIES Act creates a test program to help pregnant women on Medicaid have more options for where they give birth. Specifically, it sets up demonstration projects in up to six states that will allow freestanding birth centers—facilities that aren't part of hospitals—to get paid by Medicaid for delivering babies for women with straightforward, low-risk pregnancies.

Right now, many freestanding birth centers struggle financially because Medicaid doesn't have a clear way to pay them. This bill solves that problem by having the federal government work with selected states to figure out fair payment rates for birth center services. The bill requires birth centers to meet strict safety standards, including having accreditation from a national organization, maintaining relationships with nearby hospitals for emergencies, having both doctors and midwives on staff, and keeping at least two qualified people present during every birth. Birth centers also need to be able to handle unexpected complications and quickly transfer patients to a hospital if needed.

The program works in phases. First, the federal government gives money to states to plan their programs and help birth centers meet the requirements. Then, starting within two years, up to six states can launch their actual demonstration programs, which will run for four years. During this time, Medicaid will pay birth centers using a new payment system that covers the full pregnancy experience—from prenatal visits through 60 days after birth for the mother, and the first 28 days of life for the newborn. The bill includes $27 million in federal funding to support planning and running these programs.

The real-world impact is that women on Medicaid in participating states would gain access to birth centers as a delivery option, potentially reducing costs while maintaining safety, and states will gather data to see whether this approach actually works better than current arrangements. Congress will review the results after a few years to decide whether to expand the program nationwide.

BABIES Act

Clark, Katherine M.

Birth Access Benefiting Improved Essential Facility Services Act or the BABIES Act This bill requires the Centers for Medicare &amp; Medicaid Services (CMS) to establish a Medicaid demonstration program to improve freestanding birth center services for women with low-risk pregnancies. Among other things, the CMS must (1) publish criteria for freestanding birth centers to participate in the program, including specified accreditation, licensure, and service requirements; (2) publish guidance for states to establish prospective payment systems under Medicaid for program participants; and (3) award planning grants for states to develop program proposals. The CMS may choose up to six states to participate in the program.