The Momnibus Bill: the Groundbreaking Legislative Package

Written by nurse home visitors Becca Lipstein and Elisheva Khalfin Elbaz

The Pennsylvania MOMNIBUS 

During a recent home visit, while bouncing her 6-month-old son on her knee, one of our clients talked about having a second baby in the next two years. Interwoven with her hope to grow her family was an acute and persistent fear. Although she had physically recovered from her first delivery, she still carried the emotional scars of an urgent trip to the hospital with spiking hypertension, followed by an emergency, unexpected c-section. The question of whether she would survive a similar situation, a second time, was not just a hypothetical or hyperbole; the life-or-death stakes of pregnancy, particularly for Black women, are borne out by data. While each parent’s experience is unique, such conversations are not uncommon in our role as nurse home visitors in Philadelphia, and they arise frequently with Black women, who face disproportionate risks during childbirth.

These fears–-and the alarming reality that gives rise to them—underscore the urgent need for systemic change in maternal healthcare. To address striking disparities in Black maternal mortality, Pennsylvania legislators have introduced a groundbreaking legislative package known as the "Momnibus." This suite of eight bills aims to transform maternity care in the state. Modeled after the federal Momnibus package, the state version was introduced in March 2024 by Representatives Morgan Cephas, Gina Curry, and La’Tasha Mayes, along with other members of the PA Black Maternal Health Caucus. If passed, these bills:

• Extend Medicaid coverage for doula care

• Require Medicaid to cover at-home blood pressure monitors

• Enhance access to mental healthcare services

• Mandate implicit bias training for healthcare providers

• Identify and address ‘healthcare deserts’ with targeted resources

• Distribute essential postpartum supplies like diapers and recovery items

As public health nurses, we view these bills as crucial for addressing both a public health crisis and a fundamental issue of justice. In the U.S., Black women are three times more likely to die from pregnancy-related causes compared to white women. In Pennsylvania, the disparity is even more pronounced: in 2021, the maternal mortality rate for non-Hispanic Black women was 2.6 times higher than that for non-Hispanic White women. Each statistic here represents an incalculable loss—the death of a parent, partner, colleague, or friend—that reverberates throughout communities and across generations.

These tragedies are not inevitable; many maternal deaths are preventable. While obstetrical complications, like hemorrhage, receive frequent attention, data show that mental health conditions are leading drivers of maternal mortality in PA. As Nurse-Family Partnership nurse home visitors, we routinely screen for depression and anxiety during home visits. Early detection and referral to therapy or support services can make a significant difference. The Perinatal and Postpartum Education Act, part of the Momnibus package, aims to expand mental health education in OB offices and public settings, potentially reaching more at-risk parents. The bills were put forth during the 2023-2024 legislative session, resulting in:

Certain Momnibus bills passed both the PA House of Representatives and the Senate. This includes:

• Enhancing mental health care for pregnant and postpartum patients (HB 2127)

• Extend Medicaid coverage to doula services in the state (HB 1608)

Some bills passed the PA House of Representatives with bipartisan support and were awaiting a vote in the state Senate:

• Require insurance coverage for blood pressure monitors for home (HB 2138)

• Expand Medicaid coverage of blood pressure monitors (HB 2097)

• Providing new mothers and parents with maternal and newborn supply kits and connecting them to additional support programs (HB 2137)

No action was taken on the following bills:

• Investing in maternal healthcare deserts (HB 2136)

• Incorporating implicit bias training for healthcare providers (HB 2178)

As public health nurse home visitors working alongside families across Philadelphia, we know that passing the Momnibus legislation would save lives. Allowing people to easily monitor their blood pressure at home, supplying expecting parents with newborn essentials, and increasing access to hands-on support during and after birth will support healthy pregnancy, birth, and postpartum. Pennsylvania has the opportunity to lead the nation in maternal health. The Pennsylvania House and Senate returns to session on January 27, 2025.

For more information on the PA Momnibus bills, visit the PA Black Maternal Health Caucus website.

Citations:

Maternal Mortality Rate, 2021

Reduce Black Maternal Mortality

2024 Pennsylvania Maternal Mortality Review Annual Report 

Important Research links:

PA House Calendar

Easy Visual Summary of the Momnibus bills

Federal Momnibus Act

PA House News Release Page

PA Black Maternal Health Toolkit

2024 Maternal Mortality Review Committee Report

The Actual HB 2127 Bill about Mental Health