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H 8175Medical Services

Human Services - Medical Assistance

This legislation mandates that Rhode Island Medicaid cover breastfeeding support services provided by licensed certified lactation counselors.

Held for study
Population
Affected
18
Email Legislator
Introduced Feb 27, 2026Committee House Finance

Plain-English Summary

This bill requires Rhode Island's Medicaid program to provide coverage for services offered by licensed certified lactation counselors. These professionals assist families with breastfeeding assessment, education, and support for infants from birth up to twelve months old. The Executive Office of Health and Human Services (EOHHS) is tasked with establishing reimbursement rates comparable to similar maternal health providers and creating regulations for these counselors to participate in Medicaid. Additionally, the EOHHS must begin collecting data on the usage and cost of these services by July 1, 2028.

For younger readers

This new rule helps moms and their new babies. Sometimes, mothers need help learning how to feed their babies breast milk. There are special helpers called lactation counselors who know how to teach this. This bill says that the state's health insurance for people with less money, called Medicaid, must pay these helpers. This means more moms can get free help feeding their babies during the first year of the baby's life without worrying about how much it costs.

Who & Where It Applies

Impacted groups
Medicaid BeneficiariesLicensed Certified Lactation CounselorsInfants (0-12 months)Pregnant WomenExecutive Office of Health and Human Services
Impacted communities
All

Constitutional & Fiscal Check

None Likely

Estimated cost
Amount unknown
Estimated revenue
None

Bill Analysis

Both viewpoints
For Progressives
  • Promotes health equity by ensuring low-income mothers on Medicaid have access to the same professional breastfeeding support services as those with private insurance.
  • Improves long-term public health outcomes for children in poverty, as breastfeeding is linked to stronger immune systems and better developmental health.
  • Empowers patients by removing unnecessary bureaucratic barriers, such as the requirement for a physician's referral, allowing direct access to specialized care.
  • The restriction of coverage to infants up to only 12 months may fail to support mothers who wish to breastfeed longer, as recommended by the World Health Organization.
  • Reimbursement rates based on "comparable services" may still be too low to encourage enough private lactation counselors to accept Medicaid patients, potentially leaving service gaps.
  • The bill focuses on payment structures but does not explicitly address the need for culturally competent care or outreach to marginalized communities where breastfeeding rates are often lower.
For Conservatives
  • Supports traditional family structures and maternal roles by providing resources that facilitate infant care and breastfeeding.
  • Reduces regulatory red tape by explicitly stating that no physician supervision or referral is required for these counselors to practice.
  • Potentially lowers long-term state healthcare costs, as breastfed infants generally require fewer medical interventions and hospitalizations than formula-fed infants.
  • Expands government spending and the size of the welfare state by adding a new mandatory coverage category to the Medicaid program.
  • Increases administrative bureaucracy by requiring the Executive Office of Health and Human Services to promulgate new regulations and track specific data.
  • Interferes with market dynamics by mandating specific insurance coverage rather than allowing the market to dictate which medical services are necessary or cost-effective.

Votes

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Full Bill Text

Changes to existing Rhode Island law · 26 additions

SECTION 1. Chapter 40-8 of the General Laws entitled "Medical Assistance" is hereby amended by adding thereto the following section: 40-8-33. Licensed certified lactation counselor -- Medicaid coverage.

(a) As used in this section, “licensed certified lactation counselor” means a trained professional who holds a licensure and certification by the department of health in accordance with chapter 13.8 of title 23. Licensed certified lactation counselors provide services in assessment, evaluation, problem identification, treatment, education, and consultation to provide lactation care and services to childbearing families, and infant children from birth to twelve (12) months old within the scope of practice pursuant to § 23-13.8-9.

(b) The executive office of health and human services (“EOHHS”) shall provide coverage under the Medicaid program for services provided by a licensed certified lactation counselor, when such services are within the counselor’s lawful scope of practice and are otherwise eligible for coverage under the Medicaid state plan or a waiver approved by the Centers for Medicare and Medicaid Services.

(c) Reimbursement for services provided by a licensed certified lactation counselor shall be made in accordance with Medicaid reimbursement principles and methodologies applicable to other maternal and child health providers for comparable services. No requirement for physician or other provider supervision, signature, or referral shall be imposed unless such requirement is imposed on other providers for the same service.

(d) The EOHHS shall promulgate rules and regulations necessary to implement this section including, but not limited to, credentialing and enrollment requirements for licensed certified lactation counselors participating as Medicaid providers.

(e) On or before July 1, 2028, and annually thereafter, the EOHHS shall collect and maintain data on utilization and expenditures related to services provided by licensed certified lactation counselors to Medicaid beneficiaries.

(f) Notwithstanding any general or special law to the contrary, unless otherwise specified, the provisions of this section shall supersede and shall control over any conflicting or inconsistent laws, including general laws, special laws, or local laws, or any rule or regulation of the state.

SECTION 2. This act shall take effect upon passage.