HR-8089-119
Referred to the House Committee on Energy and Commerce.
Sponsored by Gwen Moore (D-WI)
What it does
This bill would direct HHS to issue guidance to states on diversifying maternity care teams, fund a study on culturally responsive maternity care, and create two new grant programs (totaling up to $150 million over five years) to train and diversify midwives, physician assistants, perinatal health workers, and nursing professionals. It would also require periodic GAO reports on barriers to maternal health education and care access.
Who benefits
Aspiring maternity care providers (midwives, physician assistants, nurse practitioners, perinatal health workers) who could receive scholarships or training funded by the grants; nursing and midwifery schools that could receive federal grant funding; patients in underserved and health-professional-shortage areas who may gain access to more diverse care teams; and researchers/HHS agencies conducting the mandated studies and reports.
Who is hurt
Taxpayers funding the $150 million in authorized appropriations; institutions or programs that do not meet the bill's diversity-related prioritization criteria and may be less competitive for grants; and potentially states or providers who must adapt to new HHS guidance without additional funding to implement it. Some may also view the bias/racism training curriculum requirements as an added compliance burden on grant recipients.
Supporters argue
Supporters argue that the U.S. maternal mortality rate is substantially higher than other wealthy nations, with Black and Native American women dying from pregnancy-related causes at 2-3 times the rate of white women according to CDC data, and that workforce diversity and culturally responsive care have been linked in research to improved patient outcomes and communication. They contend targeted federal investment in training midwives, perinatal health workers, and diverse nursing professionals addresses documented shortages in maternity care, particularly in health professional shortage areas.
Opponents argue
Opponents argue that the bill's prioritization criteria based on race and ethnicity in grant awards and training curricula could raise legal concerns following the Supreme Court's 2023 SFFA decision applying strict scrutiny to race-conscious programs, even though this bill involves workforce grants rather than college admissions. They contend the $150 million authorization creates a new federal program with mandated bias-training curricula and extensive reporting requirements without clear evidence the specific mechanisms chosen will measurably reduce maternal mortality disparities.
Constitutional context
Congress relies on the Spending Clause (Art. I, §8, cl. 1) to condition grant funding on institutional practices such as diversity recruitment strategies and bias-training curricula, which is a well-established exercise of spending power rather than a direct mandate. The bill's race-conscious grant prioritization criteria could face scrutiny under equal protection principles given the post-SFFA (2023) trend toward strict scrutiny of race-conscious government programs, though SFFA addressed college admissions rather than workforce development grants.
Checks and balances
Congress would authorize the spending and set program parameters, while the Executive Branch (HHS Secretary) would gain discretion to write implementing guidance, prioritize grant applicants, and determine reporting requirements, with oversight through mandated GAO and congressional reports.
Historical precedent
Title VII and Title VIII of the Public Health Service Act have long authorized health workforce training grants, and this bill follows that established model by adding new sections for perinatal-specific workforce development.