Kentucky Senate advances bill that would require Medicaid to cover some midwife services

FRANKFORT — Kentucky Medicaid would begin covering licensed certified professional midwife (LCPM) services under a bill approved Thursday by the state Senate.

Senate Bill 89 passed 34-3 after little discussion. 

Primary sponsor Sen. Shelley Funke Frommeyer, R-Alexandria, said the legislation is a chance to “innovate” in Kentucky. 

Under her bill, she said, a Medicaid-insured patient with a low-risk pregnancy could have the costs of using a certified professional midwife for a home birth covered by the federal-state health care program which already pays for about half of all Kentucky births.

Funke Frommeyer, also an advocate for freestanding birth centers in Kentucky, cited previously reported numbers showing the state recorded 177 home births in 1988 and 900 in 2021 and said mothers should have “maternity care options.” 

“We see people doing one of the following,” she said. “They may forego the care truly desired and plan a hospital birth, which is covered by Medicaid. They may make sacrifices and find a way to pay out of pocket for LCPMs. They may have a home birth without a trained provider — or sometimes without anyone at all.” 

Louisville Democrat Sen. Karen Berg, who is a physician, asked if an LCPM could do an episiotomy if needed, and Funke Frommeyer said that does fall within the scope of their practice, as does suture. 

An episiotomy is an incision in the tissue between the vagina and the anus, according to the Mayo Clinic. It may be necessary if the baby’s shoulder is stuck behind the pelvic bone, among other reasons. 

The bill can now go to the House for consideration there.