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