“Momnibus” bill to lower maternal mortality rates gets revived on last day of session

A bill aimed at lowering Kentucky’s soaring maternal mortality and morbidity rates was revived Monday, the final day of the regular session, without a last-minute amendment that had been championed by anti-abortion advocates.

House Bill 10 from Rep. Kim Moser, R-Taylor Mill, dubbed the “momnibus” bill for its many components pertaining to pregnancy and new moms, carried strong bipartisan support until last month, when a controversial committee substitute was tacked onto the bill.

That amendment proposed requiring healthcare providers to recommend women with nonviable pregnancies consider carrying those pregnancies to term rather than get abortions. But that amendment had been cleaved from the final version.

There was very little discussion on the House floor Monday before lawmakers voted to add Moser’s original bill to Senate Bill 74, a bill from Sen. Shelley Funke Frommeyer, R-Alexandria, to adjust requirements for the statewide child and maternal fatality review team.

Both the House and Senate passed the combined bill on Monday with near unanimous, bipartisan support.

A spokesperson for Democratic Gov. Andy Beshear declined to say Monday afternoon whether the governor will sign the bill into law.

The bill would do the following:

Establish pregnancy as a “qualifying life event” to be covered by Medicaid. Require Medicaid to cover lactation consultation services and the cost of breastfeeding equipment, maternity and post-partum care telehealth services and participation in an in-home program for treatment of substance use disorder. Allow pregnant women on private insurance the option to buy into temporary insurance to cover pregnancy. Maintain the Kentucky Maternal Psychiatry Access Program under the Cabinet for Health and Family Services, an emergency hotline to allow health care providers expedite referrals for patients needing mental health services.

Maintaining the hotline builds off a five-year $750,000 grant already awarded to the state to do just that.

If providers identify a mental health need for a patient, they can call a hotline and get an immediate referral to connect their patient to mental health services. The bill also would establish the Kentucky maternal and infant health collaborative to review the psychiatry access program annually.

The bill also requires public health department staff working in the home-visit program known as HANDS — health, access, nurturing development services — to offer education on safe sleep and lactation counseling and assistance. The bill would also ask the Cabinet to study Doula programs and their benefit to populations most at risk for poor perinatal outcomes.

Kentucky’s maternal mortality rates rank among the highest in the nation. Roughly half of Kentucky’s maternal deaths within the first year of pregnancy are addiction-related and preventable, Moser has said. A former nurse, she has presented her bill as a means of expanding resources to populations most at risk.

But the momnibus bill, the product of a bipartisan working group, became divisive in late March when much of House Bill 467, or the “Love Them Both Part II Act” from Rep. Nancy Tate, R-Brandenburg, was added to Moser’s bill as committee substitute.

Under Tate’s bill, all hospitals, birthing centers, maternal fetal medicine providers and midwives “shall provide or make referrals to a perinatal palliative care program, or perinatal palliative care support services” if a patient’s pregnancy is nonviable, and it would be covered by insurance.

A nonviable pregnancy is one in which the fetus is diagnosed with a condition that will lead to its death, either in utero or shortly after birth. In these situations, termination is one of a handful of options considered the standard of care health care providers offer to patients with nonviable pregnancies, as the Herald-Leader has reported.

Tate and her bill language said the point was to offer “alternatives to pregnancy termination.”

Moser said the point of adding Tate’s proposal to her bill was just to “give the patients and family the option” of carrying a nonviable pregnancy to term and the services supporting that decision would be available.

The point wasn’t to pressure women one way or the other, she said.

But Democrats decried Tate’s bill and later the amendment, saying it was means of codifying more anti-abortion language into law in a state that has already banned the procedure. During a committee hearing on Tate’s bill on March 7 that Moser chairs, three Democrats walked out in protest of the bill. Two weeks later, Tate’s bill was added as an amendment to Moser’s momnibus bill.

Rep. Lindsey Burke, D-Lexington, was one of the Democrats who walked out in protest at that March meeting.

Pleased with the final version of Moser’s bill, which no longer included the anti-abortion provisions, Burke said on the House floor Monday she had “never been more delighted, proud or excited to vote for any single piece of legislation.”

This story may be updated.