California Doubles Down on Doula Coverage: A Win for Birth Equity

In a move hailed by some as a crucial step toward improving maternal health equity, **California** lawmakers have approved a budget that will cover **doula services** for low-income residents through **Medi-Cal**. The reimbursement rate, set at **$1,154 per birth**, is more than double the state's initial proposal and significantly higher than many other states. This decision, expected to take effect in **January 2023** and cost **$10.8 million annually**, aims to professionalize the role of doulas and potentially reduce disparities, particularly for Black mothers who face disproportionately high maternal mortality rates. However, some experienced doulas and advocates argue that even this increased rate is insufficient to constitute a living wage in California, given the demanding and time-intensive nature of the work.

• California has significantly increased Medi-Cal reimbursement for doula services to $1,154 per birth.
• The new coverage aims to improve maternal health outcomes and address racial disparities, particularly for Black mothers.
• The rate is more than double the state's initial proposal but still considered insufficient by some experienced doulas.
• The policy is set to take effect in January 2023 with an estimated annual cost of $10.8 million.
• Doula services are linked to better birth outcomes, including lower C-section rates and increased breastfeeding.

California's legislative decision to cover **doula services** under **Medi-Cal** at **$1,154** per birth represents a substantial increase from the initial **$450** proposal. The state budget allocates **$10.8 million** annually for this initiative, with a **January 2023** start date. While this rate is higher than many other states, it falls below the **$1,500** offered in Oregon and Rhode Island. The actual impact will depend on how many doulas accept Medi-Cal patients at this rate and whether it sufficiently covers the intensive, on-call nature of their work.

This is a landmark victory for maternal health in **California**. By significantly increasing **Medi-Cal** reimbursement for **doula services** to **$1,154**, the state is acknowledging the vital role doulas play in improving birth outcomes and addressing racial disparities. This higher rate will likely attract more doulas to serve Medi-Cal beneficiaries, professionalize the field, and ultimately lead to better health for mothers and infants, especially for marginalized communities facing the highest risks.

Despite the doubled rate, **California's** **$1,154** reimbursement for **doula services** under **Medi-Cal** remains a 'partial victory' at best. For a state with a high cost of living and doula work that often limits clients to two or three per month due to its on-call nature, this rate is still not a living wage. Experienced doulas like **Samsarah Morgan** express 'wild unimpressed' sentiment, suggesting this will not adequately compensate for the labor and time invested, potentially failing to achieve the desired improvements in birth outcomes or address systemic inequities.

Originally reported by California Healthline