119-hr2469

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2469 Introduced in House

    (IH) ]

<DOC>

119th CONGRESS
 1st Session
 H. R. 2469

 To direct the Secretary of Health and Human Services to evaluate the 
 benefits of abortion doula care and coverage.

_______________________________________________________________________

 IN THE HOUSE OF REPRESENTATIVES

 March 27, 2025

Ms. Strickland (for herself and Ms. Moore of Wisconsin) introduced the 
 following bill; which was referred to the Committee on Energy and 
 Commerce

_______________________________________________________________________

 A BILL

 To direct the Secretary of Health and Human Services to evaluate the 
 benefits of abortion doula care and coverage.

 Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

 This Act may be cited as the ``Abortion Data and Outreach to Unlock 
and Leverage Abortion Support Act'' or the ``Abortion DOULAS Act''.

SEC. 2. DEFINITIONS.

 In this Act:

    (1) Abortion doula care.--The term ``abortion doula care'' 
 means the provision of emotional, social, informational, and 
 physical support by non-clinical, trained professionals 
 (commonly known as ``abortion doulas'') to individuals before, 
 during, and after medication and procedural abortions, 
 including such provision of practical support, patient 
 navigation support, patient advocacy, and postabortion care.

    (2) Secretary.--The term ``Secretary'' means the Secretary 
 of Health and Human Services.

SEC. 3. FINDINGS.

 Congress finds the following:

    (1) Abortion doulas provide critical support to patients 
 and families before, during, and after medication and 
 procedural abortions. Abortion doula care can encompass 
 physical, social, and emotional support; information sharing, 
 advocacy, and education; and personal care, such as planning 
 meals or providing childcare. Abortion doula care may be 
 individualized, culturally and linguistically congruent, and 
 trauma-informed.

    (2) Abortion doulas work in a variety of environments, 
 including hospitals, clinics, clients' homes, and community 
 spaces, and in both telehealth and in-person care settings. 
 They may work independently, through a collective or community-
 based organization, as part of a local health department, or 
 through or in close partnership with a health care system or 
 health plan.

    (3) While research has shown that doula support to parents 
 during labor, birth, and the postpartum period is associated 
 with better birthing experiences and healthier outcomes for 
 both parents and infants, existing evidence on doula support 
 during other reproductive health care events, such as abortion, 
 miscarriage, or stillbirth, is more limited.

    (4) A 2015 National Institutes of Health study found that 
 nearly all the women who had doulas present during first-
 trimester procedural abortions reported satisfaction with the 
 doula care they received, with many expressing support for 
 greater involvement of abortion doulas in abortion care.

    (5) In a randomized controlled trial of doula support 
 during first-trimester procedural abortions, 96 percent of 
 women who received doula support recommended that it be 
 incorporated into routine abortion care, and 72 percent of 
 women who had not received doula support wished they had 
 received it.

    (6) The Supreme Court's decision in Dobbs v. Jackson 
 Women's Health Organization and its impact on communities 
 across our nation have made access to abortion doula care more 
 important than ever.

    (7) The Dobbs decision has had an outsized impact on people 
 who already face barriers to health care access, particularly 
 Black people, Indigenous people, people of color, disabled 
 people, undocumented immigrants, low-income individuals and 
 families, young people, people in rural communities, and people 
 with limited English proficiency. The care that doulas provide, 
 which often includes culturally competent patient advocacy and 
 coordination with health care providers, can help medically 
 marginalized patients confront heightened challenges to 
 accessing appropriate medical care. Abortion doulas with a 
 lived understanding of the communities in which they work can 
 leverage local social support and connect clients and their 
 families with community resources that best meet their needs.

    (8) Additionally, in the confusing legal landscape of 
 abortion access after the Dobbs decision, abortion doulas help 
 people navigate misinformation and combat the shame and stigma 
 around abortion that restrictions may have exacerbated.

    (9) There are several barriers to accessing doula care.

    (10) Barriers include limited awareness of doula services 
 among pregnant patients and their families, members of the 
 perinatal care workforce, and other health care professionals.

    (11) The cost of doula care is another barrier to access, 
 particularly for Black people, Indigenous people, people of 
 color, people in rural communities, and low-income individuals 
 and families.

    (12) Doulas themselves face challenges such as barriers to 
 entering the field, insufficient support during the Medicaid 
 credentialing process, and low Medicaid reimbursement rates. As 
 a result, abortion doulas are often unpaid and operate within a 
 volunteer infrastructure.

    (13) Many State Medicaid programs still do not cover doula 
 services despite growing interest in expanding State Medicaid 
 coverage to include doula care. Private insurance coverage of 
 doula care is more limited. State Medicaid and private 
 insurance plans that do include doula care often do not include 
 support for abortion doula care.

SEC. 4. STUDY ON THE BENEFITS OF ABORTION DOULA CARE AND COVERAGE.

    (a) Study.--The Secretary of Health and Human Services, in 
coordination, as appropriate, with the Director of the Office of 
Minority Health and the Director of the Office on Women's Health, shall 
conduct and complete a study on the benefits of abortion doula care and 
coverage. Such study shall include an assessment of the following:

    (1) The impact of abortion doula care on the well-being of 
 individuals seeking abortions, including patient experience 
 before, during, and after seeking care.

    (2) The potential of abortion doula care to enhance the 
 quality of care provided before, during, and after abortions.

    (3) The role of abortion doulas in providing informational, 
 logistical, and practical support to individuals in the process 
 of seeking abortion care.

    (4) The availability and accessibility of abortion doula 
 care in all States of the United States.

    (b) Data Collection.--The Secretary shall collect data from a 
representative sample of individuals who have received abortion doula 
care, including the following:

    (1) Surveys of and interviews with individuals and their 
 family members who have utilized abortion doula care, including 
 those in States in which doula care for all pregnancy outcomes, 
 including abortion, is covered under State plans (or waivers of 
 such plans) under title XIX of the Social Security Act (42 
 U.S.C. 1396 et seq.).

    (2) Surveys of and interviews with practicing abortion 
 doulas and health care providers who work with abortion doulas, 
 including those in States in which doula care for all pregnancy 
 outcomes, including abortion, is covered under such plans or 
 waivers.

    (3) Review of academic literature on the subject of 
 abortion doula care.
            (c) Expert Input.--The Secretary shall consult with experts in the 
fields of reproductive health, maternal health, mental health, and 
social work. The Secretary shall also consult with community-based 
doulas and organizations that provide abortion doula care to 
individuals in underserved or rural communities.
            (d) Patient Privacy Protections.--The data collected under 
subsection

    (b) shall be anonymized to prevent the release and misuse of 
sensitive personal information.

SEC. 5. REPORT ON STATE MEDICAID APPROACHES TO ABORTION DOULA CARE 
 BENEFITS AND ACCESS.

    (a) Report.--Not later than 18 months after the date of enactment 
of this Act, the Secretary shall complete the study under 

section 4 and 
submit to the Committee on Energy and Commerce of the House of 
Representatives and the Committee on Health, Education, Labor, and 
Pensions of the Senate a report on the results of such study.

    (b) Topics.--The report under subsection

    (a) shall include the 
following:

    (1) An assessment of the potential benefits and challenges 
 of integrating abortion doula care into abortion care and 
 services.

    (2) Suggestions on how to increase access to abortion doula 
 care, especially in underserved or rural areas where access to 
 comprehensive health care may be limited.

    (3) Policy considerations and recommendations to States 
 regarding the incorporation of abortion doula care into State 
 plans (or waivers of such plans) under title XIX of the Social 
 Security Act (42 U.S.C. 1396 et seq.), with attention to 
 Federal and State regulations, eligibility criteria for program 
 participation, covered services, payment models and levels, and 
 other programs features, through changes to such plans or 
 waivers.

    (b) Public Accessibility.--The report under subsection

    (a) shall be 
made publicly available on the website of the Department of Health and 
Human Services.
 <all>