Expanding Access to Doulas

Today, the State Commissioner of Health issued a statewide standing order for doula services, expanding access for all birthing parents. The standing order – secured by Governor Hochul in the FY 2025 Enacted Budget – will allow more New Yorkers to access doula care because a recommendation for doula services is required in order to be eligible for Medicaid coverage. This standing order will serve as that recommendation. The standing order will also make it easier for birthing parents enrolled in other health plans to access doula care. Doulas provide physical, emotional, educational, and non-medical support for pregnant and postpartum individuals before, during, and after childbirth.

Despite continued efforts to reduce maternal mortality, especially among racial and ethnic minorities, the rate of pregnancy-related deaths is still far too high in New York State, especially among Black people who give birth. As of March 1, 2024, New York State Medicaid covers doula services for pregnant, birthing, and postpartum people. To support access to services, the Department maintains a directory of doulas enrolled to provide covered services to Medicaid members, pursuant to legislation signed last year by Governor Hochul. Additionally, the Doula Expansion Grant Program, secured in the FY 2025 Enacted Budget, will allow the Department to award $250,000 to community-based organizations for the recruitment, training, certification, support, and/or mentoring of community-based doulas.

Labor and delivery can present a high medical risk to pregnant persons and their newborn(s). Doula services will help to address the statewide crisis of racial and income-based maternal health disparities by providing culturally competent and comprehensive social, emotional, and physical support to clients during the prenatal, birthing, end of pregnancy and postpartum periods.

First-In-the-Nation Prenatal Paid Leave

By mandating a separate sick leave bank for prenatal care, Governor Hochul ensured that New York is going further than any other state to ensure pregnant individuals can receive the health care needed to create healthy outcomes for parent and child without jeopardizing employment.

When the policy takes effect on January 1, 2025, employees will receive an additional 20 hours of paid sick leave for prenatal care in addition to their existing sick leave.

This initiative builds on Governor Hochul’s previous actions to support new parents and improve maternal health outcomes. The FY 2024 Enacted Budget established 12 weeks of paid parental leave benefits to more than 80 percent of the state workforce and extended postpartum coverage for up to a full year for Medicaid and Child Health Plus enrollees.

Eliminating Out-Of-Pocket Costs

As part of the FY 2025 Enacted Budget, the Governor took steps to eliminate cost-sharing for certain pregnancy-related benefits, such as prenatal and postpartum visits, for those enrolled in the state’s Essential Plan or Qualified Health Plans.

The Essential Plan covers more than 1 million low-income New Yorkers, providing comprehensive benefits with $0 monthly premiums, no deductible, and low-cost sharing. It also includes free preventive care, adult vision, and dental care without cost-sharing.

Eligibility for the Essential Plan was limited to New Yorkers with incomes above Medicaid levels and up to 200 percent of FPL ($30,000 annual income for an individual). But through the recently approved 1332 State Innovation Waiver, the Essential Plan was expanded to include New Yorkers with incomes up to 250 percent of the FPL ($37,650 annual income for an individual), making the program available to an additional 100,000 New Yorkers once fully implemented. This includes nearly 70,000 New Yorkers enrolled in Qualified Health Plans who will now be eligible for significantly more affordable coverage through the Essential Plan, 12,000 DACA individuals currently enrolled in Medicaid/CHPlus, and approximately 20,500 currently uninsured New Yorkers.