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$3500 – Washington Doula Doula Medicaid Reimbursement highest in Nation!

Washington State Birth Doulas Celebrate Highest Medicaid Reimbursement Rate in the Nation

Efforts spearheaded by Doulas For All Coalition and Surge Reproductive Justice makes history with the expansion of doula care in Washington state 

Seattle, WA- The Doulas For All (D4A) coalition, a Black, Indigenous People of Color led birth doula coalition facilitated by Surge Reproductive Justice, celebrates reaching the biggest milestone in their 6 year journey to securing medicaid reimbursement for birth doulas in WA. 

On March 7th, the legislature approved their final budgets, including matching funds to support a healthy medicaid reimbursement rate for birth doulas. The state approved reimbursement rate will allow birth doulas to claim up to $3,500.00 per doula- making it the highest reimbursement rate for birth doulas in the United States. In addition, and thanks to the champion efforts of Senator T’wina Nobles (28th LD), the legislature approved an additional $100k for the development of a statewide “Doula Hub”- creating supports for doulas in navigating the medicaid billing system, as well as a referral system for Washington State Medicaid families.

The passage of these budget requests not only makes history for birth workers but also celebrates a win for reproductive justice and “community directed policy”, a strategy that is at the center of all SURGE’s policy advocacy efforts. In 2021-22, SRJ facilitated a community directed policy and lobbying process in which QT/BIPOC doulas wrote, lobbied and passed HB 1881, a bill to establish birth doulas as a new profession in WA state in order to bill medicaid for doula services. This effort strategically focused on directing the WA Department of Health (DOH) to provide a pathway for certification for birth doulas in respect to the traditional and ancestral ways that Black, Indigenous and communities of color have practiced birthwork outside of the anti-Black institutions and medically racist healthcare systems that historically harmed our communities. 

“We develop the leadership skills of our community to analyze the power dynamics, anti-Blackness and anti-Indigeneity that exists in the policy and legislative process, so that we could build our own process rooted in dismantling those power dynamics while advocating for our policy.”

— SRJ Executive Director, Jackie Vaughn

Atypical to most advocacy organizations, after the HB 1881 was passed, the Doulas For All Coalition then spent over a year participating in “rulemaking” with DOH while simultaneously  hosting several virtual “Community Cafes”, gathering thoughts and information from doulas in Washington, and around the country to develop a voluntary competency based model for state certification that would work best for all doulas with an emphasis on independent, queer and trans, Black & Indigenous doulas of color and birthing families.

“Doulas 4 All has become such a beautiful space for birth workers to have a say about their field of work and how to create a more sustainable income for those that feel called to support their community regardless of ability to pay. [Surge Reproductive Justice] has supported our skills as community organizers, giving us a living breathing example of a community led approach.” says childbirth educator & D4A Coalition member Tabitha Milian

Doulas For All is thrilled to see the vision for Medicaid reimbursement come to life as over 50% of birthing folks in Washington state are enrolled in Medicaid. Many birth workers believe having access to culturally congruent care will be key in efforts to end the Black & Indigenous perinatal health crisis as access to doulas has been proven to lower anxiety, reduce the rate of surgical birth (cesarean birth, or C-section) and other medical interventions as well as create healthier birth outcomes. Next steps include D4A working through “rulemaking” with the WA Healthcare Authority and preparing to submit a State Plan Amendment (SPA) to the federal Medicaid program this summer/fall. If all goes according to plan and the amendment is accepted, WA birth doulas will be able to take on and submit claims for reimbursement as early as January 2025.



“I am so grateful to be a part of Doulas 4 All. This has been a long process, but d4a has made it an incredible experience. I am excited for what this legislation means for tribes, doulas, and perinatal health outcomes in Washington State”. says D4A Coalition member & birth doula Cassandra Miles

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