S-4552-119
Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
Sponsored by Kirsten Gillibrand (D-NY)
What it does
The Moms Matter Act would create two federal grant programs administered by the Department of Health and Human Services. The first would award up to $25 million per year (FY2027–2031) to community organizations, healthcare providers, tribal entities, and state and local governments to expand mental health and substance use disorder services for pregnant and postpartum individuals, with priority given to areas with high rates of maternal mortality or health disparities. The second would award up to $15 million per year (FY2027–2031) to schools and training programs to grow and diversify the maternal mental and behavioral health workforce, including through scholarships and recruitment of students from underrepresented groups.
Who benefits
Pregnant and postpartum individuals, particularly those from racial and ethnic minority groups who face elevated rates of maternal mortality and severe maternal morbidity. Residents of health professional shortage areas who currently lack access to specialized maternal mental health care. Community-based organizations, nonprofit patient advocacy groups, freestanding birth centers, and tribal health organizations that would be eligible to receive grant funding. Students from underrepresented backgrounds pursuing careers in maternal mental and behavioral health. Doulas, midwives, lactation consultants, and advanced practice nurses whose roles are formally recognized under the bill's definitions. Indirectly, families and children of mothers who receive improved mental health care.
Who is hurt
Entities that do not meet the bill's priority criteria — such as organizations not operating in shortage areas or not focused on high-disparity populations — may be disadvantaged in grant competition. Taxpayers would bear the cost of up to $200 million in total authorized spending over five years. Healthcare training programs that do not emphasize diversity recruitment or bias training may be deprioritized for workforce grants. Providers not included in the bill's definition of "maternity care provider" (e.g., certain counselors or social workers) may be excluded from some program eligibility. States and localities that do not apply or qualify may see no direct benefit despite contributing federal tax revenue.
Supporters argue
Supporters argue that maternal mental health conditions — including postpartum depression, anxiety, and substance use disorders — are the leading cause of pregnancy-related death in the United States, accounting for more than 23% of maternal mortality according to CDC data. They contend that Black and Indigenous women die from pregnancy-related causes at two to three times the rate of white women, and that targeted grant funding directed at high-disparity communities is a proportionate, evidence-based response. They further argue that the workforce grant addresses a documented shortage of specialized providers, particularly in rural and underserved areas, by building a pipeline of diverse clinicians who are more likely to practice in the communities they come from.
Opponents argue
Opponents argue that the bill authorizes $200 million in new discretionary spending without a clear mechanism to measure whether grants produce lasting improvements in maternal outcomes, and that the sunset of grant funding after five years may leave communities dependent on programs that cannot be sustained. They contend that prioritizing grantees based on racial and ethnic diversity criteria in the workforce program could face legal scrutiny under equal protection principles, particularly following the Supreme Court's decision in Students for Fair Admissions v. Harvard (2023), which tightened restrictions on race-conscious selection in federally funded programs. They further argue that the underlying shortage of maternal mental health providers requires systemic Medicaid reimbursement changes, not time-limited grants, to produce durable results.
Constitutional context
Congress's authority to appropriate funds for this grant program rests on the Taxing and Spending Clause (Art. I, §8, cl. 1). The conditions attached to grants — including reporting requirements, curriculum mandates, and diversity recruitment strategies — are permissible spending conditions under existing doctrine, provided they do not rise to the level of unconstitutional coercion as addressed in NFIB v. Sebelius (2012). The workforce grant's prioritization of racial and ethnic minority recruitment may invite equal protection challenges in light of recent Supreme Court decisions tightening scrutiny of race-conscious criteria in federally funded programs.
Checks and balances
The Executive Branch (HHS/SAMHSA) gains discretionary authority to award and administer grants; Congress checks this through annual appropriations, mandatory reporting to Congress by FY2030, and the five-year sunset on authorized funding.
Historical precedent
The Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (2018) similarly used targeted federal grants to address maternal substance use disorders and expand behavioral health workforce capacity in underserved areas.