In order to understand current legislation addressing maternal mortality, we first need to understand the process of bills becoming laws. Anyone can come up with an idea for a bill, such as constituents (the voting public), a member of Congress, the president or the Executive Branch (Longest, 2016). However, only a member of either the House of Representatives or the Senate can introduce a bill. Based on the subject matter of a bill it will be assigned to a committee to review, amend, and vote on a bill. If a bill passes through a committee, it then moves to the floor for consideration, possible amending, and a vote. Both the House of Representatives and the Senate must pass a bill before it is sent to the president to sign the bill into law (The United States House of Representatives, n.d.). The process of a bill becoming a law is cumbersome, but this prevents the passing of senseless or dangerous laws. Understanding the complex judicial system and the law-making process can be tedious; the graphic below illustrates the progression.

The Institutions and Actors

Individuals, organizations, and interest groups all contribute to the development of legislation. Interest groups are particularly influential due to their resources. Legislators are often motivated to amend or repeal existing laws or introduce new laws based upon the problems that directly affect their constituents or society as a whole. The members of Congress serve the important role of sponsoring or endorsing bills to move them into committee review. The legislative committees and subcommittees within both House of Representatives and Senate operate as essential institutions for moving proposed ideas through the legislative process. The president arguably has the most control with the ability to veto a bill (Longest, 2016).

Statutory and Regulatory Mechanisms

So now that we understand the process of bills, we can evaluate what has been done and what is currently in process in terms of maternal mortality. Legislation regarding maternal mortality and its contributing factors is relatively new.

2016: H.R.34- 21st Century Cures Act. Bringing Postpartum Depression Out of the Shadows Act

A part of this Act addressed the use of federal grant money to develop and/or maintain maternal mental health programs to educate, screen, and treat postpartum depression (March for Moms, 2019).

2018: H.R.315/S.783- Improving Access to Maternity Care Act

This Act addresses the maternity health care provider shortage and helps identify the areas of greatest need (March for Moms, 2019).

2018: H.R.1318/S.1112- Preventing Maternal Deaths Act

This was the Act discussed in my first blog post. This bipartisan bill establishes a program under the Department of Health and Human Services which provides grants for states to establish and support committees to review every maternal death and based on those findings develop recommendations on how to prevent future deaths (March for Moms, 2019).

Active Legislation

H.R.4995 The Maternal Health Quality Improvement Act

This bill establishes grants for rural obstetric networks to improve access to care, telehealth resources for maternal care providers, training for providers practicing in rural areas, training for providers in implicit and explicit bias, and integrated services for pregnant and postpartum women (March for Moms, 2019).

H.R.4996 The Helping Medicaid Offer Maternity Care Services (MOMS) Act

This bill gives states the option to extend Medicaid and Children’s Health Insurance Program (CHIP) coverage from 60 days to one year postpartum for women who have pregnancy-related Medicaid or CHIP coverage. It will increase the state’s federal matching rate of 5% for one year. It also addresses Medicaid policies for the reimbursement of doula services (March for Moms, 2019).

What can you do?

Contact your legislator and voice your support of these active bills that directly benefit mothers in the United States. People that schedule meetings and directly speak to their legislator generally have their voices heard and increase their influence. Mobilizing support, writing letters, sending delegations, and motivating allies to join efforts can get the attention of government officials (Kingdon, 2011). As discussed above, the legislative process has many steps. The more support a bill garners, the easier the progression of it will be.

References

Kingdon, J.W. (2010). Agendas, Alternatives, and Public Policies, Updated Second Edition. London: Longman Publishing Group

Longest, B. B., Jr. (2016). Health policymaking in the United States. Chicago, IL: Health Administration Press.

March for Moms. (2019). Federal legislation. Retrieved from https://marchformoms.org/advocacy/federal-legislation/

The United States House of Representatives. (n.d). The legislative process. Retrieved from https://www.house.gov/the-house-explained/the-legislative-process