The Mamas and Babies in Underserved Communities Act of 2025 directs the HHS Secretary, through HRSA, to award grants to public and nonprofit health care providers that serve minority, low-income, or medically underserved communities to expand and improve prenatal, postnatal (infant), and postpartum (mother) services. The statute includes explicit priority criteria for organizations that primarily serve underserved populations, are led by people with lived experience in those communities, and are physically located in the communities they serve.
Grantees must provide culturally and linguistically appropriate care and may not spend more than 10% of grant funds on administrative costs.
The law also requires grantees to coordinate with other federally funded maternal health activities to avoid duplication, defines the postpartum/postnatal period as 12 months after birth, references the existing statutory definition of "medically underserved community," and authorizes such sums as necessary for fiscal years 2026–2030. For providers, funders, and health systems, the measure channels federal support toward community-rooted maternal services while placing clear limits on overhead and privileging local leadership as a grant-selection factor.
At a Glance
What It Does
Establishes a new Section 317K–1 in the Public Health Service Act authorizing HRSA to award grants to public or nonprofit health care providers to expand and improve prenatal, infant postnatal, and maternal postpartum care in underserved areas. The program sets priority factors, requires culturally and linguistically appropriate services, caps administrative spending at 10%, and mandates coordination with other federal maternal health programs.
Who It Affects
Public and nonprofit health care providers that serve minority, low-income, or medically underserved communities — including community health centers, federally qualified health centers (FQHCs), and community-based maternal programs — plus HRSA/HHS as the administering agency and the pregnant and postpartum women and infants these providers serve. State and local programs that already run maternal health initiatives will be potential coordination partners.
Why It Matters
The bill channels federal grant dollars specifically to locally rooted providers and requires culturally tailored services, signaling a shift toward community-led responses to maternal health inequities. The administrative cap and prioritization rules will shape which organizations can realistically participate and how they allocate funds, affecting service delivery models on the ground.
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What This Bill Actually Does
The bill inserts a dedicated grant program into the Public Health Service Act to expand and improve services across the perinatal continuum: prenatal care, care for infants in the first year, and postpartum care for birthing people during the 12 months after delivery. Rather than creating a formula program, it authorizes HRSA to run a discretionary grant competition and to set application requirements.
The statutory language focuses the program on providers that serve minority, low-income, or medically underserved communities, limiting eligible applicants to public entities and nonprofit private health care providers.
Awards will be distributed with specific priorities: HRSA must favor applicants that primarily serve underserved communities, are led by individuals who have lived, been educated, or currently reside in those communities, and are geographically located in the communities they serve. These priority criteria steer funding toward organizations with local roots and community leadership rather than large, geographically distant health systems.Grantees must deliver services in culturally and linguistically appropriate ways and are capped at using no more than 10 percent of grant funds for administrative expenses.
The statute also requires grantees to maximize coordination with existing federally funded maternal health activities and to minimize duplication — a nod to integrating rather than replicating services across programs. The bill defines the postpartum/postnatal period as 12 months after an infant's birth and incorporates the statutory meaning of "medically underserved community" from an existing provision, leaving HRSA to operationalize eligibility and program rules through solicitations and guidance.Finally, the bill authorizes funding for fiscal years 2026 through 2030 at "such sums as may be necessary," which gives HRSA discretion over award size and scope but provides no explicit appropriation level or distribution formula.
That open-ended authorization means implementation details — award amounts, performance measures, reporting requirements, and monitoring — will be determined in the grant guidance and by appropriators in subsequent budget decisions.
The Five Things You Need to Know
Section 317K–1(b) limits eligible applicants to public or nonprofit private health care providers that serve minority, low‑income, or medically underserved communities.
The statute gives priority to applicants that are community‑based in three specific ways: they primarily serve underserved populations, are led by people with lived experience in those communities, and are geographically located in the communities served.
Grantees must provide culturally and linguistically appropriate services and may not spend more than 10 percent of grant funds on administrative expenses.
The bill defines 'postnatal' and 'postpartum' as the 12‑month period following an infant’s birth, expanding the covered care window beyond many shorter postpartum definitions.
Congress authorizes 'such sums as may be necessary' to carry out the program for FY2026–FY2030, leaving total funding and award sizes to future appropriation decisions.
Section-by-Section Breakdown
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Purpose: Expand and improve perinatal services
This subsection sets the program's scope: HRSA grants can fund expansion and quality improvement for prenatal care, infant postnatal care, and maternal postpartum services, and the statute explicitly ties grant purpose to improving health outcomes and reducing disparities. Practically, this authorizes a broad range of service activities but does not enumerate an exhaustive list of allowable uses; HRSA will determine eligible activities in grant solicitations.
Eligibility: Public and nonprofit providers only
The bill confines applicants to public or nonprofit private health care providers that serve minority, low‑income, or medically underserved communities. That excludes for‑profit providers and positions community health centers, nonprofit clinics, tribal health programs, and municipal health departments as primary applicants. HRSA will need to define what it means to 'serve' these communities for application vetting.
Priority criteria for awarding grants
The Secretary must prioritize applicants that primarily serve underserved communities, are led by individuals with lived/educational/current residency ties to those communities, and are geographically located within them. These three discrete factors create an evaluative framework favoring community‑rooted leadership and proximity; the Secretary retains discretion to weight or interpret these criteria in selection notices.
Conditions on recipients: cultural competency and admin cap
Recipients must provide services in a culturally and linguistically appropriate manner and limit administrative spending to no more than 10% of grant funds. That cap is a hard statutory limit on overhead, which will affect budgeting for compliance, data systems, training, and indirect costs and may require grantees to absorb some administrative expenses or seek separate funding for infrastructure.
Coordination, definitions, and the covered postpartum period
The statute requires grantees to coordinate with other federally funded maternal health activities and avoid duplication, and it defines 'postnatal' and 'postpartum' as the 12‑month period after birth while adopting the existing statutory meaning of 'medically underserved community.' Those definitions and coordination obligations tie the program into HRSA's broader portfolio but leave operational specifics — such as required memoranda of understanding or reporting on coordination efforts — to HRSA guidance.
Authorization of appropriations and timing
The program is authorized for fiscal years 2026 through 2030 at 'such sums as may be necessary.' That open authorization gives HHS latitude to scale awards subject to annual appropriations, but it provides no statutory award size, formula, matching requirement, or mandatory performance framework — all of which HRSA must set when issuing funding opportunity announcements.
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Explore Healthcare in Codify Search →Who Benefits and Who Bears the Cost
Every bill creates winners and losers. Here's who stands to gain and who bears the cost.
Who Benefits
- Community health centers and nonprofit maternal clinics: They become the statute’s primary applicants and are positioned to receive grants to expand perinatal services and hire staff such as community health workers, doulas, or obstetric clinicians.
- Community‑led organizations with local leadership: The priority for entities led by people with lived experience favors grassroots groups and local coalitions that can demonstrate leadership ties to the communities served.
- Pregnant and postpartum people in underserved areas: The 12‑month postpartum coverage period and emphasis on culturally and linguistically appropriate care increase the likelihood of more sustained support during the high‑risk first year after birth.
- Infants and families in targeted communities: Additional funding for infant postnatal care can improve early childhood screenings, immunizations, and linkage to pediatric follow‑up services.
- State and local programs seeking federal partnership: Agencies and nonprofit partners can leverage grants to fill service gaps, especially where Medicaid coverage is limited or fragmented.
Who Bears the Cost
- HHS/HRSA: The agency will bear program design, monitoring, and technical assistance responsibilities, and must craft solicitations, evaluation criteria, and oversight processes without specified staffing or funding levels in the statute.
- Nonprofit providers' administrative capacity: The 10% cap on administrative expenses will pressure recipients to cover compliance, reporting, and infrastructure costs from program funds or other sources, which can be difficult for small organizations.
- Organizations lacking community‑rooted leadership structures: Larger or for‑profit providers without community‑based leadership or local residency ties may be disadvantaged by the priority criteria even if they operate in underserved areas.
- Existing federally funded maternal programs: Coordination requirements may force program adjustments, data sharing, or realignment of service delivery to avoid duplication, generating transitional costs and administrative work.
- State Medicaid agencies and other payors: To the extent grants support services that Medicaid typically finances, states will need to determine how grant‑funded activities interact with covered benefits and whether grants supplement or supplant existing funding.
Key Issues
The Core Tension
The central dilemma is whether the bill’s priorities and funding structure can both empower small, community‑led providers and give them the administrative capacity to run federally funded programs: it privileges local leadership and proximity but constrains overhead with a hard 10% administrative cap, forcing a trade‑off between directing funds to front‑line services and supporting the organizational backbone necessary to deliver and sustain those services.
The statute leaves major implementation choices to HRSA and appropriators, creating both flexibility and uncertainty. 'Such sums as may be necessary' authorizes funding without a dollar figure or allocation formula, which means program scale, award size, and the number of grantees depend entirely on future appropriations and HRSA’s grant design. Absent statutory performance metrics or required outcome measures, the program will rely on HRSA’s grant guidance to define success — creating risk that awards focus on activities that are easiest to measure rather than those that most effectively close disparities.
Two provisions work at cross‑purposes. The priority for community‑led organizations seeks to shift resources to local actors, but the 10% cap on administrative expenses constrains those same organizations' ability to invest in compliance, data systems, staff training, and scaling.
Small community clinics often need flexible overhead to manage grants; the statutory cap may force them to divert program dollars into direct services at the expense of sustainable infrastructure. The coordination requirement is sensible in principle but may be operationally complex: grantees will need to map federal programs, negotiate data‑sharing and referral pathways, and demonstrate non‑duplication — all tasks that take administrative time and money the statute limits.
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