Maternal Syphilis Bill Aims to Cut Infant Deaths by Standardizing Testing in Medicaid and CHIP

The new Maternal and Infant Syphilis Prevention Act tackles a serious, growing public health crisis: the massive spike in syphilis cases, especially those passed from mother to baby (congenital syphilis). The core of this bill is simple: it requires the Secretary of Health and Human Services (HHS) to issue detailed guidance within 12 months. This guidance is basically a playbook for state Medicaid and CHIP programs, as well as the Indian Health Service, on how to improve screening and treatment for pregnant women and newborns. The goal is to stop the spread of congenital syphilis, which has tragically led to 252 stillbirths and 27 infant deaths in 2023 alone, according to the bill’s findings.

The Crisis Point: Why the Urgency?

If you haven't been following the numbers, they are alarming. Syphilis cases overall hit a 70-year high in 2023, and congenital syphilis cases are now more than ten times what they were just over a decade ago. The bill points out that the vast majority of these cases—nearly 90 percent—could be prevented if the mother is tested and treated early enough. The problem is that many states only require testing during the first prenatal visit. This bill pushes for what health experts call "best practices": testing again late in the third trimester and at delivery, which is crucial for catching later infections that could still harm the baby.

The New Playbook for State Health Programs

Section 3 of the Act mandates that the HHS guidance cover specific strategies to help states and tribal health organizations close the gap. For the average person, this translates directly to better, more consistent care. For example, the guidance must address how to make screening easier, how to better educate both providers and expecting mothers, and how to use telehealth services effectively—including making sure interpreters and multilingual materials are available. Think of this as an attempt to standardize the minimum level of care across the country, so that where you live doesn't determine whether your baby is protected from this preventable disease.

What This Means for Families and Providers

If you or someone you know relies on Medicaid or CHIP for maternity care, this bill aims to make sure your doctor follows the most current, evidence-based screening schedule. For instance, if your state currently only screens once, this guidance will strongly encourage them to adopt the third-trimester and delivery testing protocols. For healthcare providers, especially those in rural or tribal areas, the guidance will offer strategies for utilizing existing federal waivers and resources to actually implement these changes, potentially streamlining processes and improving access to treatment. The bill specifically includes the Indian Health Service and related organizations, recognizing the need for tailored strategies in those communities.

The Implementation Challenge

While this bill is focused entirely on providing helpful guidance and best practices—which is a good thing—it’s important to note that the effectiveness relies on state adoption. The guidance itself isn't a federal mandate forcing states to change their laws; it’s a detailed instruction manual on how to use existing federal authorities (like Section 1115 waivers) to improve care. The bill attempts to create accountability by requiring the HHS Secretary to report publicly within two years on how well these best practices are actually being implemented across the country. This public report will be the real scorecard, letting everyone see which states are making progress and which are lagging behind in protecting newborns.