Some states are already paring back what Medicaid covers : NPR

Key Points:

• Misty Pipe, a doula on the Northern Cheyenne Indian Reservation, provides free childbirth support due to the nearest hospital with delivery services being 100 miles away, highlighting the critical need for such care in rural and underserved communities.
• Montana lawmakers approved Medicaid reimbursement for doulas last year to improve maternal care access, but the state Department of Public Health and Human Services postponed implementation citing a budget shortfall driven by rising Medicaid costs.
• The department projects a $146.3 million deficit in federal Medicaid funds this year, with further cuts expected due to recent federal legislation reducing Medicaid spending, putting optional services like doula care at risk nationwide.
• Native American communities face significant maternal health disparities exacerbated by limited local obstetric services, underfunded Indian Health Service facilities, and systemic barriers to care, contributing to higher rates of pregnancy complications and mortality.
• Despite funding setbacks, Pipe remains committed to supporting families on the reservation through grassroots efforts and training more community doulas, emphasizing the importance of culturally grounded support amid ongoing healthcare challenges.