PA budget can include doula services and essentials for new parents • Spotlight PA

HARRISBURG – Pennsylvania's public health insurance program would cover the services of a doula and new parents would receive kits of diapers and nursing pads under proposed legislation that could be included in this year's budget.

The measures are part of a “Momnibus” package backed by the Black Maternal Health Caucus of Democrats in the state House of Representatives, which was formed in 2023 in response to growing concerns about high maternal mortality rates that are even worse for Black mothers.

Governor Josh Shapiro has also proposed increased investments in maternal health as part of his $48.5 billion budget.

The Democrat is also demanding that lawmakers allocate $3 million in this year's budget to provide free tampons and sanitary pads to public school students, an idea popular in his party but met with skepticism by Republican leadership.

Democrats, including those who control the state House of Representatives, argue that new spending on health initiatives is justified given the state's $14 billion surplus. The still-growing reserves were built by strong tax revenues and savings from federal aid during the pandemic. But Republicans who control the state Senate have largely rejected calls for new programs this year, pushing for tax cuts instead.

Parliament's leaders are working to reach an agreement on the budget before the 30 June deadline, and it is possible that some of these initiatives will eventually find their way into the final product as negotiations continue.

Since May, the state House of Representatives has passed legislation that would expand access to maternal blood pressure monitoring, doulas — non-medical professionals who care for pregnant women — and treatment for postpartum depression.

Some parts of the Momnibus package are controversial. Private insurers raised concerns about a bill that would reimburse patients for blood pressure monitors after birth, while a Republican lawmaker said she was approached by medical providers who opposed a bill that would require screening for postnatal depression.

House Democrats voted unanimously to remove the screening provision from the latter bill and make the requirement to disseminate information about postnatal depression optional, but other parts of the package enjoyed broad bipartisan support.

The chamber recently voted 123 to 79 to establish a program that would send new parents baby care items such as diapers and onesies, as well as essential postpartum items such as sanitary pads and ice packs.

“You shouldn't have to get lucky to have the things you need on the first day of your child's life,” state Rep. La'Tasha Mayes (D-Allegheny), who introduced the bill, said at a news conference in March.

The federal government launched a similar pilot program in 2023, distributing 3,000 kits in three states with high rates of maternal mortality, infant mortality and postnatal depression through local hospitals and community groups. The U.S. Department of Health and Human Services is still studying the results, but survey results among recipients were positive.

Some Republicans opposed Mayes' bill, saying it should be limited to low-income parents and provide services that are already covered by insurance during hospitalization.

The state Department of Health estimates that each postpartum kit would cost the state $75 and each newborn kit would cost the state $195.

According to the department, Pennsylvania averaged nearly 133,000 births per year from 2018 to 2022. Providing a kit to every baby at the estimated prices would cost the state nearly $36 million annually.

“We're going to pay twice for some of these things,” Republican Rep. Kate Klunk of York argued in the House, adding, “This bill doesn't target the mothers who need it most.”

The state House of Representatives also recently implemented one of Shapiro's priorities: free menstrual products in public schools. “Girls have a right to peace of mind so they can focus on learning,” the governor said in his budget address in February.

Karla Coffman, a certified school nurse at York Suburban High School, told Spotlight PA that every day she sees students who are missing period products or trying to use something else instead.

Toilet paper or paper towels, while more accessible, are unhygienic, Coffman said, and can lead to embarrassment at best and infection at worst.

“You have to calm them down and get them back to learning,” she added.

So she buys a few boxes of period products each year to keep a supply. But the school district says the expense is unnecessary, and some community partners — like a church next door that runs a food bank for the school's low-income students — don't pay for tampons.

The state House of Representatives voted 117-85 for a bill that would provide $3 million for a free period product program.

Periods are “not a dirty subject to talk about. It's a natural thing,” Joanna McClinton (D-Philadelphia), speaker of the state House of Representatives, told Spotlight PA. “And it's something we should not only talk about, but more importantly, we should meet the need because we are able to.”

Most Republican lawmakers voted against the bill, including Republican Rep. Stephanie Borowicz (Clinton), who said the proposal was “another step by the governor and the Democrats to impose on you everything that leads to communism.”

Immediately after Shapiro's speech, acting state Senate President Kim Ward (R-Westmoreland) told the Pittsburgh Post-Gazette that the governor's proposal was a “straightforward, full-blown 'spend, spend, spend,'” and pointed to his call to introduce “sanitary pads in schools” as an example.

When pressed in a television interview a week later, Ward struck a more conciliatory tone, saying she was not criticizing the offer and that it did not cost much.

“If there is a need, we do it,” she said, “but no school has ever come to me and said there is a need.”

The bills are now in the hands of the Republican-dominated Senate, which must approve any new spending and has frequently criticized Democrats' spending proposals.

However, given the higher than expected government revenues, new spending may be possible.

“Divided government inevitably requires a certain amount of give and take,” state Senate Majority Leader Joe Pittman (R., Indiana) told Spotlight PA last week.

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Anna Harden

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