Honorable Governor Rick Perry;
Texas Health and Human Services Commission Executive Director, Thomas Suehs
TX Medicaid and CHIP Director Billy Milwee
Health and Human Services Council of Texas

We urge you to cover all facility fees and services provided by Licensed Midwives in Texas Birth Centers. Texas Medicaid must comply with the Birth Center section of the Patient Protection and Affordable Care Act (aka the Healthcare Reform Act). That law requires all state Medicaid plans to:
1) cover all facility fees of birth centers (including those owned or operated by Licensed Midwives); and
2) cover the professional fees of Licensed Midwives who provide prenatal care and birthing services in birth centers

Complying with this law would save the State of Texas millions of dollars each year, as demonstrated in other states. Numerous studies have proven that low-risk women who choose out-of-hospital births with Licensed Midwives receive excellent care and outcomes at a fraction of the cost of hospital births. In Texas, Licensed Midwives and Certified Nurse Midwives provide care for women in 216 counties, including 115 counties without an obstetrician (9/2008). The American Public Health Association supports "the expansion of midwifery as a key strategy to improving access to care for childbearing families."

Texas' maternal health outcomes are among the worst in the United States (22.3 maternal deaths vs. 13.3 maternal deaths nationally). Texans need better access to high quality, low-cost prenatal and birthing services. Texas Medicaid should guarantee Medicaid recipients the same choices available to those with private insurance, especially when those services cost less than what taxpayers currently pay.

Please conserve scarce state funds by giving Medicaid patients access to high-quality, low-cost maternity service. Cover all services provided by Licensed Midwives in birth centers. Further savings could also be realized by covering ALL Medicaid-eligible births attended by Licensed Midwives and Certified Nurse Midwives.

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