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For Immediate Release
August 6, 2013

Contact: Damaris Hay
[email protected]
Office: (240) 485-1856

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Leading US Midwifery Organization Applauds Legislation to Correct Affordable Care Act Inequity Affecting Midwives, Other Primary Health Care Providers

American College of Nurse-Midwives Supports Legislation to Improve Medicaid Reimbursement

Silver Spring, MD – The American College of Nurse-Midwives (ACNM), the leading professional organization of midwives in the United States, applauds Rep. Suzanne Bonamici (D-OR) on her introduction of the Protecting Access to Primary Care Act, (H.R. 2986). The bill would correct an inequity in the Affordable Care Act (ACA) that provides higher reimbursement to some physicians but fails to equitably compensate certified nurse-midwives, nurse practitioners, clinical nurse specialists, and physician assistants who also provide primary care services, as authorized by state law.

“We know that we need more primary care providers to meet the needs of our population,” said Bonamici. “The legislation I introduced makes a small but significant change to the ACA that will encourage more primary care providers to care for Medicaid patients.”

According to ACNM, while midwives are well known for attending births, 53.3% of certified nurse-midwives (CNMs)/certified midwives (CMs) identify reproductive care and 33.1% identify primary care as their main responsibilities in their full-time positions. Their work includes annual exams, writing prescriptions, basic nutrition counseling, parenting education, patient education, and reproductive health visits. Additionally, Medicaid reimbursement for CNM care is mandatory in all states. Congress has recognized the value of CNM services by setting their payment under Medicare at 100% of physician rates. The majority of states also mandate private insurance reimbursement for midwifery services.

“ACNM is supportive of this legislation because of the focus it places on equitable reimbursement for midwives and the high-quality services midwives provide women of all ages under Medicaid,” said ACNM President Ginger Breedlove, CNM, PhD, APRN, FACNM. “Midwifery-led care for primary and maternity care is on the rise while providers in the field are declining. ACNM is working to educate women on their provider options so they can have access to the care that is the best fit for them and their families.”

Access to primary and maternity care was highlighted in a June 2013 Medicaid and CHIP Payment and Access Commission (MACPAC) landmark report to Congress. The report noted that there were 1.8 million deliveries under Medicaid in 2008 (46 percent of total births in the US) at a cost of more than $11 billion to states and the federal government. It described the challenges to come with the expansion of the Medicaid program and focuses on critical issues relating to access to primary care and maternity care providers.

Breedlove noted that midwives have a long history of serving Medicaid beneficiaries by providing wide access to the primary and maternity care services they offer. The MACPAC report highlights the challenge of ensuring this access continues with significant workforce shortages on the rise.


About the American College of Nurse-Midwives

The American College of Nurse-Midwives (ACNM) is the professional association that represents certified nurse-midwives (CNMs) and certified midwives (CMs) in the United States. With roots dating to 1929, ACNM sets the standard for excellence in midwifery education and practice in the United States and strengthens the capacity of midwives in developing countries. Our members are primary care providers for women throughout the lifespan, with a special emphasis on pregnancy, childbirth, and gynecologic and reproductive health. ACNM reviews research, administers and promotes continuing education programs, and works with organizations, state and federal agencies, and members of Congress to advance the well-being of women and infants through the practice of midwifery.



American College of Nurse-Midwives.
8403 Colesville Rd, Suite 1550 | Silver Spring MD 20910
Phone: 240-485-1800 | Fax: 240-485-1818
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