State Capitol Week in Review

September 4, 2026

Arkansas expanded its maternal health services on September 1 when Medicaid began reimbursing doula and lactation consultant care under rules recently approved by the Arkansas Legislative Council. The move follows the council’s Administrative Rules Subcommittee endorsement and completes a process initiated by two laws passed in 2025: the Healthy Moms, Healthy Babies Act and Act 625.

The Healthy Moms, Healthy Babies Act directs $45 million annually toward improving maternal outcomes and requires the Department of Human Services (DHS) to create Medicaid reimbursement for doula services.

Arkansas Act 625 updates the state’s rules for Medicaid’s provider‑led care system. It allows certain Medicaid patients to go through a shorter, simpler evaluation process when they sign up with organizations that manage care. The change is meant to support new maternal health efforts and make it easier for people to get the care they need.

The policy arrives as Arkansas continues to rank among the states with the highest maternal and infant mortality. According to the Centers for Disease Control and Prevention, Arkansas’ maternal mortality rate was roughly 36 deaths per 100,000 live births in recent years, which is significantly higher than the national average. Infant mortality also remains high, with around 7.8 deaths per 1,000 live births, placing Arkansas among the ten worst‑performing states. The state’s healthcare landscape is further strained by rural hospital closures; 53 of Arkansas’s 75 counties no longer have hospitals with labor and delivery units, forcing many families to travel long distances for care.

Doula coverage is intended to improve outcomes in this environment. Research from the Cochrane network found that women receiving doula support experienced shorter labor, were less likely to undergo cesarean deliveries, and reported more positive birth experiences. With Medicaid covering about 60% of births statewide, supporters say reimbursing doulas could expand access to a service shown to reduce complications.

Expectant parents have welcomed the change. Many reported difficulties affording doula care, particularly those on Medicaid who faced major decisions during labor without additional support. Advocates say the new policy will help level access across income levels.

To participate in Medicaid, doulas must follow a two‑step enrollment process. First, they must receive certification through the Arkansas Department of Health, which verifies training and credentials for community‑based doulas. After certification, doulas may apply to DHS to become Medicaid providers. DHS began outreach on September 1, launching an online portal with enrollment instructions, required forms, and training materials. According to DHS, once doulas submit complete applications, the Division of Medical Services typically processes approvals within 15 days. Only after approval can doulas bill Medicaid for services, and many expect an initial learning curve as providers adapt to insurance billing practices.

Maternal health advocates say implementation will require ongoing work, particularly in rural counties where provider shortages are most severe. They encourage the state to explore incentives to keep doulas practicing in underserved communities. Still, the new reimbursement rules mark a significant step toward improving maternal care statewide and expanding access to support for expecting families.