Idaho Medicaid to Cover Licensed Midwives? How ’bout Texas?

In February, Texans for Midwifery, powered by over 100 midwives and consumers went to the Capitol to tell legislators how the state could save money and improve outcomes by covering the services of Licensed Midwives under the State’s Medicaid plan. The overwhelming response, “uh, why aren’t we doing this already?”

This week, the State of Idaho passed legislation to do just this. Lawmakers saw the $ signs and the potential to improve outcomes and voted almost unanimously in favor of the bill, joining 11 other states that already cover these services.

Kind of a no brainer, right? Lower costs, improve outcomes? Makes sense? The state of Texas is currently in a budget crisis. One of the proposed solutions is to cut the Medicaid reimbursement rates paid to physicians. When this happens, doctors drop out of the plan and low-income women have fewer options or cannot find maternity care. What happens then? They show up at expensive emergency rooms and we see declining outcomes.

So how about this? The state covers Licensed Midwives > women on Medicaid have the option to choose a midwife and out-of-hospital birth > more women get quality care > the state potentially saves enough money to prevent reimbursement cuts to physicians, preventing a shortage. That seems like a win-win. Is it just me?

Nope, not just me. Over 350 people have signed TfM’s petition to the TX Health and Human Services Commission. And you can too!

Still not convinced? Here’s a few facts:

  • In Texas, Licensed Midwives (over 200) and Certified Nurse Midwives provide care for women in 216 counties, including 115 counties without an obstetrician
  • In Texas, Medicaid pays over over half of all births in the state
  • Midwife-attended births have significantly reduced rates of preterm birth and low birth weight. These major contributing factors to infant mortality also escalate long term care costs. The medical costs for one premature baby cover a dozen healthy births, according to the March of Dimes.
  • Midwife-attended births involve far fewer costly and preventable interventions. This includes a five-fold decrease in cesarean surgeries.
  • The State of Washington reported $3.1 million in Medicaid savings over two years after it gave low-risk women the option to birth with a midwife outside the hospital. Texas’ population is four times larger, promising much greater savings.

Did you want a midwife, but were unable to afford one because you were on Medicaid?  Tell me about it, and sign the petition.

About Brielle

I am a Licensed Midwife and doula/monitrice in Austin, TX and a very happy homeschooling mama to my two amazing children.
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2 Responses to Idaho Medicaid to Cover Licensed Midwives? How ’bout Texas?

  1. KDN says:

    The improved outcomes only exist in Certified Nurse Midwife attended-births in freestanding birth centers and hospitals. With licensed midwife attended-births at home, several very well-conducted studies found a three-fold increase in neonatal mortality.

    • Brielle says:

      I’d love to know about these “several very well-conducted studies.” The recent Wax meta-analysis showed a three-fold increase in neonatal mortality but its methods were flawed and it has even been questioned in Nature and the Lancet. I am not aware of any studies that show improved outcomes between home vs. birth center or CNM vs. CPM but I’d love to see them if you would be willing to share. A great article on the topic is

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