2025 State Regulations
Alabama
Alaska
Louisiana
Michigan
Alabama is currently not accepting doulas under Medicaid. However, there are ongoing efforts to explore this possibility. The Department of Mental Health has funded BirthWell Partners to run a Community Doula Project, supporting pregnant individuals with substance use disorders. Moreover, in 2023, organizations including March of Dimes, Women’s Foundation of Alabama, and BirthWell Partners formed a committee to investigate integrating doula care into Medicaid coverage. At present, doulas in Alabama do not need to take any additional steps to become state-certified, as DoulaVersity's certification is all that is required to practice. We will continue to update our certified doulas on any new developments in this area.
Currently, Alaska does not accept doulas under Medicaid. However, the state is supporting doula services through a program run by the Anchorage-based organization Due North Support Services. This state-funded community doula program offers free care to pregnant and postpartum individuals, focusing particularly on vulnerable populations. While Medicaid does not directly cover these services, the existence of such programs highlights the recognition and support for doula care at the state level. DoulaVersity’s certification is sufficient for practicing in Alaska, and no additional state certification is required at this time. We will keep our community informed about any changes regarding Medicaid acceptance of doula services.
Arizona
In 2023, UnitedHealthcare, one of Arizona state’s Medicaid managed care plans, began offering doula services. Arizona's approach to doula practice and certification provides flexibility and voluntary participation in a state certification program. Click HERE for more information.
Arkansas
California
In 2023, UnitedHealthcare, one of Arizona state’s Medicaid managed care plans, began offering doula services. Arizona's approach to doula practice and certification provides flexibility and voluntary participation in a state certification program. Click HERE for more information.
California initiated its Medicaid doula benefit on January 1, 2023, making comprehensive doula services available to all pregnant and postpartum individuals, irrespective of immigration status. The coverage is inclusive, supporting various pregnancy outcomes such as labor and delivery, abortion, miscarriage, and stillbirth. In November 2023, California set a precedent as the second state, following Michigan, to recommend doula services statewide. By December 2023, CMS endorsed an increase in California’s doula Medicaid reimbursement rates to a maximum of $3100, the highest nationwide.
For details on how to apply for these benefits, please visit: California Doula Medicaid Application.
DoulaVersity’s program meets all of the criteria to be a Medicaid-approved doula in California.
Colorado
Colorado is actively in the process of implementing this coverage.
In April 2023, Colorado Governor Jared Polis included doula care in the state budget, marking a significant step towards enhanced maternal health services. By May 2024, he had signed SB23-288, mandating the state to initiate a stakeholder process for Medicaid coverage of doula services. This legislation also calls for a report on the stakeholder findings, the pursuit of CMS approval for Medicaid doula coverage by July 1, 2024, the establishment of a scholarship program for doulas serving Medicaid enrollees, and an assessment of the cost-benefit for including doula care in private insurance policies. The expected reimbursement rate for doulas is set at $1500.
conneticut
Connecticut is actively in the process of implementing Medicaid coverage for doula care, having passed several pieces of legislation over the past three years to pave the way. In 2021, Public Act No. 21-35 tasked the Commissioner of Public Health with reviewing the scope of practice to establish a state certification process for doulas, culminating in a committee report published in March 2022. The following year, HB 5500 was enacted, creating a Doula Advisory Committee to recommend training and continuing education standards for doula certification, alongside a Doula Training Program Review Committee to continually assess training programs that meet these criteria. In June 2023, further progress was made with the signing of HB 986, which defined specific requirements for doula certification and reaffirmed the roles of the existing committees. Concurrently, the Department of Social Services is integrating doula care into its upcoming HUSKY Maternity Bundle Payment Program, transitioning maternity care payments from a fee-for-service model to a bundled payment approach. The rollout of the state’s doula Medicaid benefit is anticipated in September 2024.
Delaware
Delaware passed HB 343 in July 2022, which required the Division of Medicaid and Medical Assistance to create a plan for Medicaid coverage for doula care. In August 2023, HB 80 was signed into law, which required the Division to create a process for doulas to be certified and to enroll as Medicaid providers, and specified that the doula Medicaid reimbursement rate be established “that supports a livable annual income for full-time practicing doulas.” The Division is holding regular meetings with a Doula Ad Hoc Committee on implementation of the doula Medicaid benefit, and anticipates rolling out the benefit in 2024.
Florida
Florida began providing Medicaid coverage for doula care when it was introduced as an optional expanded benefit within Medicaid managed care. Consequently, only those enrolled in Medicaid managed care plans in Florida, which constitutes 87% of all Medicaid enrollees in the state, are eligible for doula services. Since these services are managed at the state level, the Agency for Health Care Administration lacks broad authority or control over how the benefit is implemented. Therefore, each Medicaid managed care plan in Florida has the autonomy to define the extent and management of the benefit, including setting the credentialing standards and reimbursement rates.
Georgia
Georgia has initiated a doula pilot program managed by two Medicaid-managed care plans in the state, serving as preliminary steps toward eventual widespread implementation across the state. Additionally, Healthy Mothers, Healthy Babies Georgia oversees a Doula Access Working Group dedicated to promoting legislation and advocating for Medicaid coverage of doula care, further supporting the expansion of these services.
Hawaii
In April 2022, Hawaii passed resolution SCR2 SD1, which mandated the state auditor to conduct a sunrise review on the certification and regulation of community health workers, including doulas. The findings were published in September 2022 in the "Sunrise Analysis: Regulation of Community Health Workers." Since then, there has been no further action taken. To ensure that doulas are recognized and accepted by Medicaid, more decisive and active efforts are needed to advance this cause.
Idaho
Illinois
Idaho has not yet implemented any measures to facilitate the reimbursement of doula services by Medicaid.
Indiana
Iowa
In 2019, Indiana passed SB 416, which opened the possibility for doulas to be reimbursed under Medicaid and allowed for the submission of a State Plan Amendment or waiver to enable coverage. However, the necessary funding for this initiative was not included in the state budget. Since the provisions in SB 416 were optional rather than mandatory, the Medicaid benefit for doulas was never implemented. In August 2022, SB 2 was enacted, establishing a Doula Reimbursement Advisory Board, but progress on forming the Board and actualizing the Medicaid benefit remains unclear more than a year later. Meanwhile, the Indiana Minority Health Coalition continues to lead the Indiana for Doulas movement, actively engaging with doulas and other stakeholders through public education, advocacy, and efforts to draft potential new legislation.
Iowa’s Department of Health and Human Services is currently running a Maternal Health Doula Project under the state’s Title V Maternal and Child Health Service Block Grant. This pilot project aims to offer culturally appropriate, community-based doula care to tackle the disparities observed in Black maternal and infant health outcomes. The Department intends to use the insights gained from this pilot to advocate for broader access to doula services. Additionally, one of Iowa’s Medicaid managed care plans, Iowa Total Care, is providing doula services to pregnant enrollees in Polk, Johnson, or Muscatine counties.
Kansas
Kentucky
In 2021, Louisiana enacted HB 190, establishing the Louisiana Doula Registry Board responsible for setting criteria for doula registration and approving applications. More progress was made in June 2023 when HB 272 was signed into law, mandating that private health insurance plans covering maternity services also provide coverage for doula care, with reimbursements potentially reaching up to $1500. This makes Louisiana the second state to mandate doula care coverage through private insurance and the first to do so without corresponding Medicaid coverage for doula services.
However, it is important to note that the Doula Registry Board is not currently accepting applications for the Statewide Doula Registry. For updates on when the board will begin to accept and review applicants, please refer to the official meeting minutes of the Doula Registry Board.
Maine
Maine is currently in the process of implementing statewide doula services, facilitated by the Maine Doula Coalition which was established in 2022. This group is dedicated to improving access to doula services for birthing individuals, ensuring equitable reimbursement for doulas, and enhancing birth experiences and perinatal outcomes across the state.
Maryland
Maryland introduced Medicaid coverage for doula services in February 2022 with an initial four-year funding authorization. Subsequent legislation later in the year made this coverage permanent. The State Plan Amendment facilitating this change was ratified in June 2022, establishing a reimbursement rate of up to $930 for doula care.
DoulaVersity has been accepted as one of Maryland Medicaid’s approved doula training organizations.
Massachusetts
Massachusetts initiated its Medicaid doula benefit on December 8, 2023, coinciding with the issuance of a statewide standing recommendation for doula services. This action positioned Massachusetts as the third state to endorse such a recommendation. The Massachusetts Doula Coalition has been actively engaged in organizing meetings, town halls, and various advocacy and educational initiatives across the state since at least 2020. The reimbursement rate for doula services under Medicaid in Massachusetts is up to $1700.
To enroll and learn more about the eligibility criteria, please visit: MassHealth Doula Services Program Information for Doulas
Mississippi
Missouri
In 2020, Michigan introduced a bill, SB 965, to provide Medicaid coverage for doula care. Although the bill was not passed, it initiated discussions within the Department of Health and Human Services about the possibility of adding doula services as a Medicaid benefit. By April 2022, the Department committed to integrating doula care into Medicaid services and formed the Michigan Doula Advisory Council. The necessary State Plan Amendment was approved in June 2022, and the doula Medicaid benefit commenced on January 1, 2023. On the day the benefit started, Michigan’s Chief Medical Executive officially recommended doula services, marking Michigan as the first state to issue such a recommendation. The reimbursement rate for doula services is set at $1150.
DoulaVersity has applied (1/8/25) to be an approved organization with the state of Michigan.
Minnesota
Minnesota passed legislation in 2013 to cover doula services under Medicaid, with the benefit starting in 2014. On January 9, 2024, Minnesota implemented a statewide standing recommendation for doula services, further solidifying the state's commitment to this essential care.
In Minnesota, doula services are limited to the scope of a qualified health professional, must train through a state-approved organization, and must pay for a listing on a registry of doulas. Under the Minnesota system, doula services are connected to an NPI, which adds a clinical lens to doula care. Minnesota’s policy limits the scope of practice for doulas and adds cost barriers to being paid by Medicaid. Moreover, rather than choosing what skills the accreditation should reflect, Minnesota Medicaid chooses specific accrediting organizations whose credentials become necessary for employment as a doula. Read here for more information
Missouri
Mississippi has not yet implemented any measures to facilitate the reimbursement of doula services by Medicaid.
Mississippi has not yet implemented any measures to facilitate the reimbursement of doula services by Medicaid.