S. 5515 — CARE for Moms Act

This section states congressional findings on maternal mortality in the United States, reporting nearly 4,000,000 annual births, more than 1,000 maternal deaths, and 70,000 near-fatal complications each year, with the rate rising from 14.5 to 32.0 deaths per 100,000 live births from 2000 to 2021. It highlights racial disparities, with rates of 69.9 for non-Hispanic Black women and 32.0 for American Indian/Alaska Native women versus 26.6 for White women, notes that over 80 percent of deaths are preventable, and identifies leading causes including hemorrhage, cardiovascular conditions, and mental health disorders.

This section establishes the State-Based Perinatal Quality Collaborative Grant Program and authorizes $35 million annually for FY2027 through FY2031 to award grants of up to $250,000 per year for development and sustainability of perinatal quality collaboratives in each state, the District of Columbia, and eligible territories. It requires states to cover oral health services for pregnant and postpartum women under Medicaid, defined as dental services to prevent disease, promote oral health, restore function, and treat emergencies during pregnancy and the following 12 months, with minimum coverage for preventive, diagnostic, periodontal, and restorative care. It also mandates 12-month continuous full-benefit coverage for pregnant and postpartum individuals under Medicaid and CHIP.

This section establishes a grant and contract program to grow and diversify the full-spectrum doula workforce. It authorizes eligible entities—including health professions schools, academic health centers, state and local governments, Tribes, and community-based organizations—to use funds for doula education and training programs, capacity expansion with scholarships for service in underserved communities, and recruitment of students from groups experiencing high maternal mortality rates. It appropriates $50,000,000 for fiscal year 2027, to remain available until expended.

This section establishes a 5-year pilot program authorizing the Secretary of Health and Human Services to award grants to States for purchasing and equipping rural mobile health units to deliver pre-conception, pregnancy, postpartum, and obstetric emergency services in rural and underserved communities; training providers including obstetrician-gynecologists, certified nurse-midwives, nurse practitioners, nurses, and midwives; and addressing access barriers such as nutrition, housing, lactation, and transportation services. It authorizes $10 million annually for fiscal years 2027 through 2031, prohibits sharing personally identifiable information with law enforcement, requires State reports at 3 and 6 years after grant receipt with data stratified by race, ethnicity, and other categories, and directs the Secretary to evaluate the program by December 31, 2032, and report to Congress within one year of completion.

This section requires hospitals participating in Medicare to notify the Secretary of Health and Human Services at least 90 days before closing any obstetric unit. The notification must include a report analyzing the closure’s impact on the community, steps the hospital will take to identify other providers that can address resulting service gaps, and any additional information the Secretary requires. The requirement applies beginning 180 days after enactment.

This section directs the Secretary to submit to Congress, within 2 years of enactment, a report analyzing where maternal health needs are greatest in the United States and Federal expenditures addressing them from 2000 through 2024. The report must examine distribution of funds across regions, States, and localities; barriers to applying for and receiving funds, including partnership and network requirements; reasons applicants were denied funding; and data on mothers served disaggregated by race, ethnicity, insurance status, and language spoken.

This section doubles the excise tax on small cigarettes and small cigars to $100.66 per thousand (from $50.33), on large cigarettes to $211.38 per thousand (from $105.69), on snuff to $26.84 per pound (from $1.51), and on chewing tobacco to $10.74 per pound (from 50.33 cents). It sets pipe tobacco and roll-your-own tobacco at $49.56 per pound, taxes large cigars at $49.56 per pound (minimum 10.066 cents per cigar), imposes a $100.66-per-thousand tax on discrete single-use smokeless tobacco units, taxes other FDA-regulated tobacco products at the cigarette rate on a per-use basis, and adjusts all rates for inflation after 2026.