New HEALTH for MOM Act Offers States Enhanced Funding to Extend Medicaid Maternity Care for One Year Postpartum

The Harnessing Effective and Appropriate Long-Term Health for Moms On Medicaid Act of 2025, or the HEALTH for MOM Act, is all about fixing a major gap in maternal care. It gives states the option to set up a new system called a “maternity health home” for women on Medicaid who are pregnant. If a state adopts this, the biggest win is that eligible women get their comprehensive care coordinated throughout pregnancy and for one full year after delivery, provided they still qualify for Medicaid (SEC. 2).

The Care Coordinator: What’s a Maternity Health Home?

Think of a maternity health home as a quarterback for medical, mental health, and social support services. This isn't just about doctor visits; it’s about making sure everything—from behavioral health to dental care and even social services like WIC or home visits—is coordinated and accessible (SEC. 2). For a provider team to qualify as a health home, they have to prove they can create a personalized, patient-centered care plan and coordinate quick access to all needed services. This is a game-changer for new moms who are often left scrambling to manage multiple appointments and complex needs during the exhausting postpartum period.

The Financial Incentive for States

To get states to actually implement this, the federal government is offering a significant financial boost. For the first four fiscal quarters a state runs this program, the federal share of the payment gets an extra 15 percentage points tacked on (up to 90% total federal funding). This enhanced funding is designed to cover the cost of setting up these coordinated systems. For taxpayers, this means the federal government is heavily subsidizing the initial investment in better maternal health infrastructure, potentially leading to long-term savings by preventing costly complications and emergency room visits down the line.

Monitoring the Real-World Impact

The bill requires serious data collection, which is critical for accountability. States must track outcomes like whether the program reduces hospital stays and lowers overall costs due to better coordination. They also have to report detailed data on severe maternal morbidity—that is, life-threatening complications—and maternal deaths that occur within the first year postpartum (SEC. 2). By requiring hospitals to notify a woman’s health home if she visits the ER, the bill tries to ensure follow-up care doesn't fall through the cracks. This focus on verifiable metrics is essential for proving the program is actually improving health outcomes, not just adding paperwork.

The Catch: It’s All Optional

While the bill offers a powerful framework and financial incentive, it’s entirely optional for states to adopt and voluntary for both women and providers to participate. This means that if your state chooses not to take the federal funding and implement the program, you won't see these extended benefits or coordinated care options. Furthermore, the Secretary still needs to define the “specific standards” that maternity health homes must meet, which leaves some initial vagueness about quality control. If states don’t set competitive payment rates for these homes, high-quality providers might decide the administrative hassle of coordination isn't worth it, potentially limiting access despite the best intentions of the law.