Youngkin signs several maternal health bills, tweaks another on unconscious bias training

Gov. Glenn Youngkin signed several bills aimed at improving maternal health in the commonwealth, building on promises both he and Democratic leadership made to support parents and health care workers. 

Dubbed the “Momnibus” package, the Democrat-led bills stem from a Black Maternal Health Summit hosted last year in the state Capitol that brought medical professionals, advocates and lawmakers from across the state and beyond for roundtable discussions and panels. Alongside these conversations, a rural health committee spent months touring Virginia, gathering firsthand accounts of maternal care gaps in underserved communities. 

Resulting legislation included bills aimed at addressing disparities, from requiring implicit bias training for medical license renewals to strengthening obstetrics training in hospitals and expanding support for midwives and doulas.

While the state has previously allocated funding to boost OB-GYN and family practice medical residencies in the state, maternal healthcare workers like midwives and doulas are more likely to live longer-term in the areas that they serve. Both are key players in filling rural health care gaps as well as addressing health care disparities for patients of color. 

To that end, Youngkin has signed Senate Bill 1352 and House Bill 1635, which build on a 2021 law that allowed some midwives to establish private practices after completing 1,000 training hours under agreements with other physicians. The new bills, by Sen. Kannan Srinivasan, D-Loudoun, and Del. Joshua Cole, D-Spotsylvania, respectively, will extend that opportunity to other types of midwives.

Relatedly, Youngkin didn’t fully approve but also didn’t outright reject House Bill 1923, which would create more pay parity for midwives. In lieu of a signature, his amendment requires the Health Insurance Reform Commission conduct an assessment and that if the legislature accepts his tweaked version of the bill, it would be subject to reenactment next year. 

Bolstering emergency responses, Youngkin also signed House Bill 1904 by Del. Rodney Willett, D-Henrico, which will allow midwives and nurse practitioners to be on 24-hour on-call duty rosters. The governor further approved  House Bill 2753 by Del. Cliff Hayes, D-Chesapeake, which requires hospitals and outpatient birthing facilities to establish protocol for identifying and responding to obstetric emergencies. He also signed House Bill 2083 by Del. Irene Shin, D-Fairfax, which will establish a special enrollment period for qualified pregnant people on Virginia’s health insurance exchange.  

A survey the state conducted last year showed long wait times for new enrollees’ paperwork to be processed. This contributed to delayed access to care for people to schedule their appointments.

Likely veto ahead on unconscious bias training bill

Though Youngkin followed through on his stated goals of remedying maternal health care issues, for the second year in a row he is seeking an amendment on the unconscious bias training bill.

Senate Bill 740 by Sen. Mamie Locke, D-Hampton and House Bill 1649 by Hayes would require workers to complete unconscious bias and cultural competency training to renew medical licenses. 

The bills have been carried for several years in a row. Last year, with bipartisan co-patrons and supporting votes, they reached Youngkin’s desk where he also sought amendments before vetoing them. 

Like last year, Youngkin’s substitute strips the mention of cultural competency and unconscious bias, adding instead “populations that data indicate experience significantly greater than average maternal mortality, postpartum complications and infant mortality.”

Studies show that Black people are more likely to experience negative maternal health outcomes, in part, due to providers’ racial bias. Black women are also more likely to die from pregnancy-related complications than white women, data from the Centers for Disease Control and Prevention shows. 

Youngkin’s substitute also would limit the training to two hours. 

Locke, who has carried the Senate version of the bill for several years, said that “no one can overcome unconscious bias and cultural incompetence by viewing a two-hour video.”

As she did last year, she plans to reject his substitute, which will likely garner another veto from the governor. 

“My point to him is he needs to overcome his own implicit bias regarding Black maternal health issues,” Locke said. “It is clear that he has no clue.” 

While Youngkin has been supportive of doulas, which are key companions and advocates for parents-to-be, his amendment to a bill to expand doula state health insurance coverage postpartum left one of its patrons perplexed. 

House Bill 1614 by Del. Adele McClure, D-Arlington, and Senate Bill 1418 by Sen. Lashrecse Aird, D-Petersburg, could allow for Virginia’s health insurance to cover up to 10 doula visits — four during pregnancy and six afterwards. 

Youngkin’s substitute changes the semantics by removing the words “birthing people” and changing it to “birthing women.” 

Though most pregnancies are experienced by cisgender women, transgender and nonbinary people with uteruses can still get pregnant, groups that  the original language of the bill would have included. The governor’s amendment also removed a provision referring to “culturally appropriate and individualized care.” 

Aird called it “frustrating” to see the removal of culturally tailored care from her bill. She also said his fixation on gendered language is “distracting from what really matters — getting people the care they need to improve outcomes and save lives.”

This article first appeared on Virginia Mercury and is republished here with permission. Virginia Mercury is part of States Newsroom, a network of news bureaus supported by grants and a coalition of donors as a 501c(3) public charity. Virginia Mercury maintains editorial independence.