We are raising funds to help support the expenses of volunteers who have been spending their own time and money going to/from the Iowa State Capitol to engage with legislators on legislation to remove freestanding birth centers from Certificate of Need.
We have made significant progress in the past few weeks. Learn more below about the active legislation below. In addition to contacting your Iowa legislators to let them know you support this bill, please contribute what you can to help our volunteer lobbyist continue this critical work.
Background:
HF 277, sponsored by Rep. Kaufmann and passed out of the House Health and Human Services Committee 19-0, would remove birth centers from the meaning of institutional health facility.
This would effectively exempt freestanding birth centers from Iowa’s Certificate of Need law, which is a barrier to maternity care providers that want to open birth centers. Iowa is one of only a handful of states that currently has zero birth centers. Currently, 30% of Iowa counties are classified as a maternal health desert, which could benefit from a freestanding birth center.
According to the American Association of Birth Centers, certificate of need laws are associated with fewer birth centers in a state. Research has shown birth centers improve outcomes, narrow racial disparities, enhance patient satisfaction, and reduce costs to state Medicaid programs and other payers.
Iowa is in the minority of states that require a certificate of need for birth centers (less than 15 states). Among nearby states, Minnesota, South Dakota, Nebraska, Kansas, Missouri, and Wisconsin do not require a certificate of need for birth centers.
A 2019 report confirmed that birth centers deliver improved health outcomes at a lower cost, averaging 21 percent lower cost of birth and 15 percent lower cost for care for women and infants for the first year after birth.
The Institute for Medicaid Innovation's 2020 report on Improving Maternal Health Access, Coverage, and Outcomes in Medicaid indicated that midwife-led care—including in freestanding birth centers—results in improved care, better outcomes, and costs less.
Iowa has Certified Nurse Midwives that currently want to open freestanding birth centers in Iowa communities without a hospital providing obstetric services, yet they are unable to do so due to the excessive cost and uncertain outcome. In 2013, a group of Certified Nurse Midwives in Northwest Iowa were denied their CON request.