The Arkansas House of Representatives approved a bill Wednesday that supporters lauded as necessary to improve the state’s maternal health care landscape, despite a handful of lawmakers expressing concerns about a section regarding alleged medical injuries during childbirth.
House Bill 1427 is the Healthy Moms, Healthy Babies Act, sponsored by Rep. Aaron Pilkington, R-Knoxville. Gov. Sarah Huckabee Sanders announced the initiative last week, calling it a “comprehensive, collaborative approach” to improving low-income Arkansans’ access to health care during pregnancy and childbirth.
Much of the legislation would alter the state’s Medicaid program by establishing presumptive Medicaid eligibility for pregnant Arkansans, offering reimbursements for doulas and community health workers and establishing pregnancy-related Medicaid coverage for specific treatments.
Sen. Missy Irvin, R-Mountain View, is the bill’s lead Senate sponsor and is also sponsoring the identical Senate Bill 213, which the Senate approved Wednesday.
The Healthy Moms, Healthy Babies policy package will cost the state $45 million per year, with $13 million set aside in Sanders’ proposed fiscal year 2026 state budget and the rest coming from federal funds, Pilkington told the House on Wednesday.
Only 34 hospitals in 23 of Arkansas’ 75 counties have labor and delivery units, and five maternity wards have closed since the onset of the COVID-19 pandemic in 2020, most recently in Newport. Pilkington mentioned the Newport closure while urging his colleagues to vote for the bill.
“We’re just trying to make it a little less expensive to operate a labor and delivery unit here in the state of Arkansas,” he said. “We have to stop the bleeding.”
Arkansas has one of the highest maternal mortality rates in the nation, and the third-highest infant mortality rate, according to the Arkansas Center for Health Improvement.
There are things in this bill that are probably not as palatable as others, but if we’re going to move this needle, this is the first step to moving that needle.
– Rep. Jeff Wardlaw, R-Hermitage
Four House Republicans said they supported most of the bill but could not vote for it because of a clause on the final page that would make a child’s fifth birthday the statute of limitations for any actions against alleged medical injuries during birth.
Little Rock attorney Paul Byrd spoke against the bill in Wednesday’s House Committee on Public Health, Welfare and Labor meeting for the same reason. Byrd said it would be difficult to determine any neurological damage to a child at all, let alone what caused it, before the age of five.
Current law, which HB 1427 would amend, allows a minor or his or her legal guardian to “commence an action” on an alleged medical injury by the child’s 11th birthday or two years after the injury occurred, depending on which is later.
Rep. Jimmy Gazaway, R-Paragould, called the bill’s statute of limitations section a “poison pill” that “doesn’t belong” with the rest of the policy package.
“This could be sent back to committee, that portion could be taken out, and we could pass this bill with 100% [of the] vote,” Gazaway said.
Pilkington said childbirth is “a very small window” that the five-year statute of limitations would cover, and he added that the Arkansas Trial Lawyers Association is neutral on the legislation.
Gazaway and five other Republicans voted present on the bill, while two more did not vote.
Reps. Jack Ladyman of Jonesboro, Julie Mayberry of Hensley and Jim Wooten of Beebe also spoke against the final clause of the bill, and all three voted against it, along with fellow Republicans Hope Duke of Gravette, James Eaton of Huntsville and David Ray of Maumelle.
State lawmakers aim to tackle Arkansas’ maternal health crisis with new legislation
Ladyman also spoke against and voted against the bill during Wednesday’s committee meeting.
All 19 House Democrats and the remaining 67 House Republicans voted for HB 1427. Five Republicans spoke in favor of the bill, including Reps. Mary Bentley of Perryville and Jeff Wardlaw of Hermitage, who are cosponsoring the legislation.
“There are things in this bill that are probably not as palatable as others, but if we’re going to move this needle [on maternal health], this is the first step to moving that needle,” Wardlaw said.
Rep. Ashley Hudson, D-Little Rock, is the bill’s sole Democratic sponsor.
More than half of births in Arkansas are covered by Medicaid, according to Arkansas Department of Human Services officials. HB 1427 would not expand Medicaid coverage for postpartum mothers from 60 days to 12 months after birth, a federal option that all other states have adopted to some extent.
Pilkington is sponsoring a separate bill to create this policy, House Bill 1004. House Minority Leader Andrew Collins, D-Little Rock, has filed the similar House Bill 1008. Both bills have yet to be heard in committee.
The Senate Committee on Public Health, Welfare and Labor will be next to consider HB 1427.