S-5283-119
Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
Sponsored by Cory Booker (D-NJ)
What it does
This bill would create numerous federal grant programs, task forces, and reporting requirements aimed at reducing maternal mortality and health disparities, covering topics such as social determinants of health, WIC eligibility, perinatal workforce diversity, maternal mental health, incarcerated pregnant individuals, telehealth, climate change risks to mothers, and vaccination outreach. It would extend WIC (Special Supplemental Nutrition Program) eligibility for postpartum individuals from 6 months to 24 months, authorize dozens of new grant programs with specified appropriations (e.g., $100 million/year for social determinants grants, $100 million/year for community-based organizations, $5 million/year for bias training), and direct HHS, VA, GAO, and the National Academies to produce numerous studies and reports over the next several years.
Who benefits
Pregnant and postpartum individuals generally, particularly those in communities with high maternal mortality rates; community-based organizations, Tribal and Urban Indian organizations, and minority-serving institutions eligible for new grants; midwives, doulas, lactation consultants, and other perinatal health workers who would gain funded training and workforce-development opportunities; incarcerated pregnant individuals who would benefit from restrictions on shackling and new care programs; veterans receiving maternity care through the VA; and researchers and academic institutions receiving study contracts.
Who is hurt
Federal taxpayers who would fund the authorized appropriations (potentially several hundred million dollars over five years); hospitals, health systems, and maternity care providers that would face new compliance, training, and reporting obligations under the respectful maternity care programs; state and local corrections agencies that would need to implement new policies on shackling and prenatal care for incarcerated individuals; and entities not prioritized under the bill's targeting criteria (e.g., providers or organizations outside racial/ethnic minority-serving categories) who may have reduced competitive access to some grant funds.
Supporters argue
Supporters argue that the United States has the highest maternal mortality rate among wealthy nations, with stark racial disparities—Black women die from pregnancy-related causes at roughly three times the rate of white women according to CDC data—and that this bill takes a comprehensive, evidence-based approach addressing both clinical and nonclinical drivers of these deaths. They contend that extending WIC eligibility to 24 months postpartum, funding perinatal workforce diversification, and ending the shackling of incarcerated pregnant individuals are targeted, low-cost interventions with demonstrated potential to save lives and improve outcomes for underserved populations.
Opponents argue
Opponents argue that the bill creates dozens of overlapping grant programs, task forces, and reporting mandates that could result in significant administrative duplication and cost without clear mechanisms to measure whether the spending actually reduces maternal deaths. They contend that some provisions tying grant eligibility and outreach priority to race and ethnicity may raise equal protection concerns following recent Supreme Court rulings restricting race-conscious government programs, and that the sheer scope of the bill—spanning climate change, telehealth, incarceration, and veterans' care—stretches the definition of a focused maternal health measure into a broad policy vehicle.
Constitutional context
Congress's authority to create these grant programs and appropriate funds rests on the Taxing and Spending Clause, and the conditions attached to grants generally fall within Congress's discretion so long as they are not unduly coercive to states or recipients. Several provisions that prioritize funding or outreach based on race or ethnicity may face scrutiny under the Equal Protection component of the Fifth Amendment's Due Process Clause, particularly following the Supreme Court's 2023 ruling limiting race-conscious decision-making in Students for Fair Admissions v. Harvard, though that case addressed university admissions rather than public health grants.
Checks and balances
Congress would authorize and appropriate funds while directing HHS, VA, and other executive agencies to design and administer numerous grant programs and task forces, with oversight provided through mandatory reports to Congress and GAO audits rather than direct congressional control over implementation details.
Historical precedent
Similar "Momnibus" legislation addressing maternal mortality has been introduced in prior Congresses since 2020 but has not been enacted in full, though some individual provisions (such as extended postpartum Medicaid coverage) have been adopted separately by Congress and states.