Does the “One Big Beautiful Bill Act” (OBBBA) Directly Impact Maternal Health Benefits?

The article was updated in January 2026 to remove top lines that were not specific to pregnancy and postpartum Medicaid coverage and provide added context on indirect impacts of Federal funding cuts.

If you are like me, since President Trump signed it into law July 4, you’ve been asking whether the “One Big Beautiful Bill” (now referred to as HR-1) directly impacts the perinatal population, including maternal health and maternal mental health benefits. 

I’ve spent several days researching the final bill’s impact on mothers. The bill will result in millions of Americans losing access to health insurance, disproportionately harming low-income people. Yet, the perinatal population was not explicitly targeted by Medicaid and SNAP food assistance spending cuts, child tax credits are being expanded, and other family financial benefits are being offered. At the same time, broader Medicaid reductions stemming from federal funding cuts and lower enrollment may indirectly affect perinatal care by reducing provider availability, limiting services, or even prompting closures.

HR-1 does not explicitly cut support for the perinatal population, as detailed below:

Food Assistance Cuts

While HR-1 reduces Federal funding of SNAP food assistance benefits, it does not cut food assistance to those who are pregnant or in the postpartum period. Currently, SNAP benefits exempt pregnant women and those with children in the household under the age of 18 from the work requirement (which requires adults to work 20 hours a week). Learn more about previous SNAP work requirements here. The new law expands work requirements to individuals ages 55 through 64, parents of minor children ages 14 and up, and veterans. It is unclear when these new rules will go into effect.

Medicaid Cuts and Health System Impact 

Medicaid, the state-federal health program for low-income families, is projected to eliminate insurance coverage for 11.8 million people over the next decade, according to the nonpartisan Federal agency, the Congressional Budget Office.

Though HR-1 will make substantive cuts to Medicaid, it does not specifically cut pregnancy or postpartum Medicaid extension coverage. States continue to have the authority to provide this coverage. However, some states may consider rolling back this coverage due to federal reductions in Medicaid funding. Given the bipartisan nature of preventing maternal deaths and improving maternal health, I hope that such actions will not be taken in any state. 

It’s also important to note that the new Medicaid work requirements do not apply to those who are pregnant or caregivers. Caregivers are defined in the bill as “parent, guardian, caretaker relative, or family caregiver of a dependent child 13 years of age and under or a disabled individual.” Even with these federal work requirement exemptions, the new work requirements will generally create more administrative burdens for enrollees filing for exemptions and for state Medicaid agencies in processing paperwork. 

Given the magnitude of the general population that will lose coverage, hospitals, which are required by law to provide care to the uninsured under the federal Emergency Medical Treatment & Labor Act (EMTALA), are expected to have an influx of patients, and patients without insurance. This will significantly impact care delivery, not just to the Medicaid population but to all Americans, particularly in vulnerable rural communities.

Tax Credits and Financial Support for Infants and Families

The OBBBA provides tax credits and funding to infants and parents. Here are the details: 

Child Tax Credit 

OBBBA extended the child tax credit, which was set to expire this year without Congressional action, and raised the credit from $2000 to $2,200 beginning in 2026. 

“Trump Accounts” for Newborns and Children

Parents can now open tax-free investment accounts on behalf of children under 18. Republicans are referring to these accounts as “Trump Accounts,” which are available to U.S. citizens. For children born from 2025 through 2028, the government will contribute $1,000 to the account. Parents can contribute up to $5,000 as well, and employers may contribute up to $2,500. These accounts will help their children with future life expenses such as college or a down payment on a home. These accounts are available regardless of income. 

Adoption Tax Credit Enhancement 

Currently, parents who adopt children are provided with a $10,000 tax credit to offset the care of the adoptive child. Previously, the credit would reduce a tax bill, but wouldn’t result in a refund even if the amount of the credit was greater than the tax bill. HR-1 now allows up to $5,000 to be refunded. 

Note, HR-1 did not address expecting mothers who choose adoption for their babies. In the U.S., expecting mothers going through the adoption process are not compensated through government subsidies for their care or living expenses; however, private adoption agencies generally provide this financial assistance. The adoption industry is known to be poorly regulated in most states. 

Employer-Provided Child Care Credit 

The Federal government previously offered employers a tax credit to offer childcare benefits to their employees as a means to incentivize them for doing so. It is estimated that the benefit only supports about 12% of the population. According to a report from Congress.gov, the childcare credit is rarely claimed by businesses.

OBBBA expands the annual employer-provided child care credit from $150,000 to $500,000 with higher percentages for small businesses.

Note that additional employer-sponsored benefits, such as Dependent Care Assistance Programs, were addressed in the bill, which I am not detailing below.  

We will continue to monitor and report on the implementation of these changes, including any proposed reduction in benefits such as postpartum Medicaid extension or reimbursement for maternity care by State Medicaid Agencies (SMAs), including those who have participated in our state policy fellows program.

I used the Google search function, including its AI summaries, to support my research and analysis for this blog post.