HAP Resource Center

Advocacy Correspondence: PA House of Representatives, Support for House Bill 1608

April 15, 2024

The Honorable Dan Frankel
Chair, House Health Committee
The Pennsylvania House of Representatives
P.O. Box 202023
Harrisburg, PA 17120-2023

The Honorable Kathy L. Rapp
Minority Chair, House Health Committee
The Pennsylvania House of Representatives
P.O. Box 202065
Harrisburg, PA 17120-2065


Dear Chairman Frankel and Chairwoman Rapp: 

On behalf of more than 230 members statewide, The Hospital and Healthsystem Association of Pennsylvania (HAP) writes to support House Bill 1608. Sponsored by Representative Morgan Cephas, this bill would extend Medicaid coverage to doula services and create a Doula Advisory Board. 

Pennsylvania hospitals are involved in the delivery of approximately 97 percent of the more than 130,000 births across the commonwealth each year and are deeply invested in continuous improvement for healthy pregnancy, childbirth, and postpartum care. 

HB 1608 would require Medicaid to pay for professional doula care, such as providing physical/emotional services during pregnancy, childbirth education, childbirth support, and up to one year of postpartum intervention. There is evidence that pregnancy and childbirth outcomes can be improved with doula care. Having a doula present during childbirth is associated with reduced cesarean sections, epidurals, and instrumental deliveries.  

Doulas are trained, competent health care providers. To assure professional competency and ensure patient safety, HB 1608 creates a Doula Advisory Board to be responsible for setting standards and determining accreditation for the profession. Additionally, the bill requires a doula who wishes to participate in the Medicaid program to carry liability insurance and submit to a criminal background check. 

More than 12 percent of women in Pennsylvania and more than 47 percent of women in rural counties live over 30 minutes from a birthing hospital. Doulas extend the health care workforce into areas that may otherwise lack access to comprehensive maternity care. Doulas complement the care provided by and collaborate with other members of the health care team—including obstetricians, midwives, nurses, lactation consultants, mental health professionals, and others—to coordinate comprehensive care for pregnant and postpartum patients and their families. By fostering collaboration and communication among all professionals, they support a patient-centered approach to maternity care and can help every provider maximize their skills and contributions within the team. 

About 33 percent of births in Pennsylvania are covered by Medicaid. It is widely understood that Medicaid reimbursement provisions do not always include the full, necessary scope of services and do not cover the actual cost of providing care. This is particularly true in prenatal, obstetric, and postnatal care. One way to help ease the strain of our current health care workforce crisis, improve patient outcomes, and care for Pennsylvania’s young families is to ensure sufficient Medicaid reimbursement that covers all available services that can contribute to high-quality care, including access to doulas. 

Again, on behalf of the hospital community, HAP supports this legislation. Thank you in advance for your consideration. If you have any questions or concerns, please contact me at SWatkins@HAPonline.org or by phone (717) 814-7176. 


Stephanie Watkins 
Senior Vice President, Advocacy and Policy 

c: The Honorable Morgan Cephas; Members of the House Health Committee 



Topics: Access to Care, Medicaid, Population Health, State Advocacy

Revision Date: 4/15/2024

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