Virginia lawmakers call for study on whether insurers must cover doula care

Two bills that would have required private insurers in Virginia to provide coverage for state-certified doula care were unanimously struck down last week by lawmakers in both houses, who instead called for a study of the proposal.

The bills will now go to the Senate Health Insurance Reform Commission, which is responsible for studying compulsory health insurance benefits.

Of the. Nadarius Clark, D-Portsmouth, and Senator Jennifer Boysko, D-Fairfax, described their identical bills as a way to help reduce maternal mortality and alleviate some of the disparities in care received by women of color and white women during and after pregnancy. Studies have shown that doulas—non-medical professionals trained to provide a wide range of support services during pregnancy, childbirth, and the postpartum period—significantly improve outcomes for parents and children, especially in populations low income and minority.

In 2020, the General Assembly adopted legislation create a state certification process for doulas, which means they must complete training approved by the Virginia Board of Health.

Clark and Boysko’s legislation this year would have required private health plans that include obstetric services to cover at least eight doula visits for pregnant women during and after pregnancy, as well as support during labor and delivery.

The United States has one of the highest maternal mortality rates compared to other developed countries, Boysko told the Senate Trade and Labor Committee last week. Black women are nearly three times more likely than non-Hispanic white women to die from complications related to pregnancy and childbirth, according to the US Centers for Disease Control and Prevention.

“There is a plethora of data and studies that have shown tremendous benefits and cost savings from providing doula care,” said Galina Varchena, policy director of Birth in Color RVA, an organization focused on on providing motherly care to women of color who also worked on Clark’s Bill.

Clark said in an interview that there were complications during his own delivery that he still suffers from.

“We know there are still implicit biases and different things that happen in our prenatal care system and our health care system,” he said.

In 2020, after study by the Health Insurance Reform Commission, the General Assembly adopted legislation make state-certified doula care available to Medicaid users.

Virginia currently has 87 state-certified doulas and about 100 Medicaid members have received doula services so far, Rebecca Dooley, communications director for the Virginia Department of Medical Assistance Services, said in an email.

Douglas Gray of the Virginia Association of Health Plans told a House Commerce and Energy subcommittee last week that “generally in the commercial world we have people who are licensed rather than people who are certified, it has to so have a conversation about how that would work.”

The State Corporation Commission and the Virginia Bureau of Insurance will do a preliminary analysis of the costs and benefits of private insurance coverage for doulas before the Health Insurance Reform Commission holds public hearings on the proposal, said said Dave Wesolowski, chief of staff to HIRC Chairman Sen George Barker, D-Alexandria, in an email.

By “opening that door to allow private insurance to cover doula care,” Clark said, Virginia can “start giving people who haven’t had the floor to finally get care.”

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