Letter to Hon. Joseph R. Biden, Jr., President of the United States, Hon. Nancy Pelosi, Speaker of the House, and Hon. Charles E. Schumer, Senate Majority Leader - Adams Urges Biden Administration, Congress to Include Maternal Health Equity in Final Reconciliation Bill

Letter

Dear President Biden, Speaker Pelosi, and Majority Leader Schumer,

As negotiations continue on the Build Back Better reconciliation package, we urge you to ensure
that critical investments to advance maternal health equity are included in full in the final
package. Specifically, we write to express our strong support for all the maternal mortality
investments in Sections 31041-31056 and postpartum Medicaid coverage investments in Section
30723 of the Build Back Better Act legislation that has advanced in the House Committee on
Energy and Commerce. In total, these provisions cost approximately $3 billion -- a fraction of a
percent of the overall package -- yet the impact would be significant, and the need could not be more urgent.

As you know, the United States has the highest maternal mortality rate of any high-income
country and the only rate that is rising. The pregnancy-related mortality rate for Black and Native
Americans is two to four times higher than the rate for white Americans, and Hispanic and
AAPI people also experience elevated rates of maternal mortality and morbidity. These trends
could worsen due to the COVID-19 pandemic, which has put pregnant people at greater risk for
adverse birth outcomes.

Recognizing the pressing need to address these alarming trends, the Energy and Commerce
Committee's Build Back Better Act legislation included historic investments to save moms'
lives, end racial and ethnic maternal health disparities, and advance birth equity across the
Untied States. The legislation would:

* Provide $175 million in funding for local entities to address social determinants of
maternal health like housing, nutrition, and environmental conditions -- including a
minimum of $75 million exclusively for community-based organizations working to
promote maternal health equity.
* Provide $275 million to grow and diversify the perinatal health workforce, including
nurses, midwives, physicians, doulas, and maternal mental and behavioral health
professionals -- including $50 million specifically for doulas.
* Provide $100 million for maternal mental health equity grant programs.
* Provide $85 million to address the impacts of climate change-related maternal and infant
health risks through health professional schools.
* Provide $50 million to advance maternal health research at Minority-Serving Institutions
like Historically Black Colleges and Universities, Tribal Colleges and Universities,
Hispanic-Serving Institutions, and AAPISIs.
* Provide $50 million to promote representative community engagement in Maternal
Mortality Review Committees.
* Provide $160 million to strengthen federal maternal health programs like the CDC's
Surveillance for Emerging Threats to Mothers and Babies program, Enhancing Reviews
and Surveillance to Eliminate Maternal Mortality (ERASE MM), Pregnancy Risk
Assessment Monitoring System (PRAMS), and the National Institute of Child Health and
Human Development (NICHD).
* Provide $60 million to expand access to digital tools and technologies that promote
maternal health equity.
* Provide $25 million for bias trainings among health care professionals.

These evidence-based investments from the Black Maternal Health Momnibus Act (Momnibus)
center the families most severely impacted by our nation's maternal health crisis, and the
provisions were shaped by women of color and local organizations that are on the ground in
communities across the country, doing urgently important work to support pregnant people and
new parents. To fulfill President Biden's priority of advancing racial equity in the Build Back Better reconciliation package, we must include these investments in full in the final package.

The Build Back Better Plan also includes a mandatory provision from the Mothers and Offspring
Mortality & Morbidity Awareness (MOMMA's) and Maximizing Outcomes for Moms through
Medicaid Improvement and Enhancement of Services (MOMMIES) Act that will make federal
funds permanently available for states to spend on expanded postpartum Medicaid and CHIP
coverage to one year in every state, with full state plan benefits throughout pregnancy and the
yearlong postpartum period.

This critical investment builds on important progress we made through the American Rescue
Plan Act of 2021, which included a provision to create a pathway for states to extend postpartum
Medicaid coverage from the current standard of 60 days to one full year after the end of a
pregnancy. While this state plan option was a significant step, expanding postpartum coverage
remains optional for states, and the American Rescue Plan provision expires in five years. The
Build Back Better reconciliation package is a once-in-a-generation opportunity to make yearlong
postpartum Medicaid coverage a permanent reality for every mom in every state: we must get it
done.

Permanently expanding postpartum Medicaid coverage and advancing comprehensive
investments in the Momnibus will uphold a principle that is fundamental to the Build Back
Better Plan: that in America, every family has a right to thrive--a principle that begins with a
safe and healthy pregnancy and birth. We must include these critical maternal health equity
investments in the final Build Back Better reconciliation package and we look forward to
working with you to deliver on behalf of the mothers, babies, and families who are counting on
us.

Sincerely,