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Midwives and Women Celebrate 2nd Anniversary of the Affordable Care Act

Twenty million. That’s the number of women who have received preventive care without co-payments this last year thanks to the health care law. But twenty million is more than a number: it’s a mother who will stop putting off that mammogram, a grandmother who will stop choosing between paying rent or a lifesaving colonoscopy, or a woman who will finally get help to quit smoking.

March 23 is the second anniversary of the Affordable Care Act. ACNM fought hard over the past several years to have federal legislation address concerns of midwives and the women we serve. The following are a list of key provisions ACNM supported:

  • Equitable Reimbursement of Midwives under Medicare: CNMs are now reimbursed at 100% of the Part B fee schedule, equivalent to physicians—a sharp increase over the previous 65% rate.

  • Coverage for Freestanding Birth Center Services: Serrvices provided by freestanding birth centers ar enow covered under Medicaid.

  • Home Health Care: The face-to-face encounter required prior to certification for home health services may be performed by a physician, nurse practitioner, clinical nurse specialist, certified nurse-midwife, or physician assistant.

  • Medical Liability Reform: Authorizes grants to states to test alternatives to civil tort litigation. Models are required to emphasize patient safety, disclosure of medical errors, and the early resolution of disputes. Patients would be able to opt out of these alternatives at any time.

  • Advanced Nursing Education Grants: Strengthens language for accredited nurse-midwifery programs to receive advanced nurse education grants in Title VIII of the Public Health Service Act.

  • Nurse Education, Practice, and Retention Grants: Awards grants to nursing schools to strengthen nurse education and training programs and to improve nurse retention.

  • Nursing Loan Repayment and Scholarship Program: Adds faculty at nursing schools as eligible individuals for loan repayment and scholarship programs.

  • Nurse Faculty Loan Program: Establishes a Federally-funded student loan repayment program for nurses with outstanding debt who pursue careers in nurse education. Nurses agree to teach at an accredited school of nursing for at least 4 years within a 6-year period.

  • Nursing Student Loan Program: Increases loan amounts and updates the years for nursing schools to establish and maintain student loan funds.

  • Graduate Nurse Education Demonstration Program: This provision directs the Secretary to establish a demonstration program to increase advanced practice nurse education training under Medicare and authorizes $50 million to be appropriated from the Medicare Hospital Insurance Trust Fund for each of the fiscal years 2012 through 2015 for such purpose.

  • Maternal, Infant, and Early Childhood Home Visiting Programs: Provides funding to States, tribes, and territories to develop and implement one or more evidence-based Maternal, Infant, and Early Childhood Visitation models. Model options would be targeted at reducing infant and maternal mortality and its related causes by producing improvements in prenatal, maternal, and newborn health, child health and development, parenting skills, school readiness, juvenile delinquency, and family economic self-sufficiency.

  • Support, Education, and Research for Postpartum Depression: Provides support services to women suffering from postpartum depression and psychosis and also helps educate mothers and their families about these conditions. Provides support for research into the causes, diagnoses, and treatments for postpartum depression and psychosis.

  • Women’s Preventive Health Services: Eliminates cost sharing for women’s preventive health services.

  • Patient Protections: Requires that a plan enrollee be allowed to select their primary care provider, or pediatrician in the case of a child, from any available participating primary care provider. Precludes the need for prior authorization or increased cost-sharing for emergency services, whether provided by in-network or out-of-network providers. Plans are precluded from requiring authorization or referral by the plan for a female patient who seeks coverage for obstetric or gynecologic care.


Two years later, how is the ACA influencing midwifery practice? Check out our FAQ Midwives and Medicare After Health Care Reform.  


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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