The Nationally Enhancing the Well-being of Babies through Outreach and Research Now Act (NEWBORN Act) would authorize a new infant mortality pilot program program funded through HRSA. Grants would be awarded to eligible entities—counties, cities, Tribal health departments, or state health departments in states with centralized health systems—to create, implement, and oversee pilots in areas with the highest infant mortality rates.
Grants can run for up to five years and prioritize work that addresses birth defects, preterm birth and low birth weight, sudden infant death syndrome, maternal pregnancy complications, and injuries to infants. Eligible activities include community needs assessments, outreach to at-risk mothers, standardized access to social, educational, and clinical services, postpartum care, and targeted counseling and support (including smoking cessation, nutrition, mental health, and domestic violence services).
The act also requires rural outreach and a regional public education campaign and coordination with local health authorities and existing infant-m Mortality reduction efforts. Funding is capped: no more than 10 percent of a grant may be used for evaluation, with annual reporting due to the Secretary.
The bill authorizes $10 million per fiscal year from 2025 through 2029 to support these pilots.
At a Glance
What It Does
The Secretary, through the Administrator, will award grants to eligible entities to create and oversee infant mortality pilot programs. Grants may last up to five years, with priority given to areas with the highest infant mortality and to programs addressing specific risk factors and conditions.
Who It Affects
Eligible entities include county, city, Tribal health departments, or state health departments. Rural areas and at‑risk mothers and infants in high‑mortality counties are primary direct beneficiaries, with local health systems and service providers playing key roles.
Why It Matters
These pilots are designed to generate rigorous evidence on effective interventions for preventing infant mortality in the communities that bear the heaviest burden, while building local capacity and coordinating existing programs.
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What This Bill Actually Does
The NEWBORN Act would add a formal, federally funded program to test ways to reduce infant deaths in communities with the worst outcomes. The Health Resources and Services Administration (HRSA) would give five-year grants to eligible local or state health entities to design, implement, and oversee targeted infant mortality pilot programs.
Preference goes to counties or groups of counties with the highest mortality rates, and to programs addressing birth defects, preterm birth, SIDS, maternal complications during pregnancy, and injuries to infants. Grants may be used to develop community plans, conduct outreach to at-risk mothers, and build standardized systems to improve access to and quality of social, education, and medical services for healthy pregnancies and healthier infants.
Programs would also include rural outreach and a regional public education campaign about infant mortality and its prevention. Each grantee must report within one year of receiving a grant and annually thereafter; the Secretary will use these reports to evaluate the pilots.
The act also establishes definitions for the Administrator, eligible entity, and Tribal, and authorizes $10 million per year from 2025 through 2029 to fund the pilots. The bill places a cap of 10 percent on how much of grant funds may be used for evaluation and requires collaboration between local health departments and existing infant mortality-reduction entities.
Overall, the NEWBORN Act aims to build a foundation of evidence-based practices in high-need areas that can be scaled if successful, while ensuring local ownership and coordination with broader public health efforts.
The Five Things You Need to Know
The bill creates a new infant mortality pilot program authorized by HRSA.
Grants go to eligible county, city, tribal, or state health departments, up to five years.
Priority is given to counties with the highest infant mortality rates and to programs addressing major risk factors (birth defects, preterm birth, SIDS, maternal complications, injuries).
Funds may be used for planning, outreach, standardized access/quality systems, postpartum care, and targeted counseling—plus rural outreach and public education.
$10 million per year is authorized from 2025 through 2029 to support these pilots.
Section-by-Section Breakdown
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Short Title
This Act may be cited as the Nationally Enhancing the Well-being of Babies through Outreach and Research Now Act, or the NEWBORN Act.
Infant Mortality Pilot Programs — grant authority and program design
The Secretary, acting through the Administrator of HRSA, shall award grants to eligible entities to create, implement, and oversee infant mortality pilot programs. Grants may run for up to five years. Preference is given to eligible entities serving counties or groups of counties with the highest infant mortality rates (as determined by the most recent three years of national data) and to programs addressing at least one of: birth defects; preterm birth/low birth weight; sudden infant death syndrome; maternal pregnancy complications; or injuries to infants. Grant funds may be used for community planning, outreach to at-risk mothers, and the development of standardized systems to improve access to and quality of social, educational, and clinical services, including counseling, postpartum care, prevention of premature delivery, and additional supports such as smoking cessation, nutrition, mental health, domestic violence, and parenting services. A rural outreach program and a regional public education campaign are required components, and coordination with local health departments and existing infant mortality reduction entities is expected. Administrative costs for evaluation are limited to 10 percent of the grant. Grantees must submit annual reports detailing methodology, outcomes, and statistics, which the Secretary will use for evaluation and research.
Authorization of Appropriations and program renaming
The paragraph that previously described grant authorities is redesignated as the Healthy Start Initiative (excluding subsection (e)). In addition, there is authorization of $10,000,000 for each fiscal year 2025 through 2029 to carry out subsection (e), supporting the infant mortality pilot programs.
Definitions and cross-reference updates
Key terms are defined: Administrator (the HRSA Administrator), Eligible Entity (counties, cities, Tribal health departments, or state health departments in states with centralized health departments), and Tribal (as defined by the Indian Health Care Improvement Act). Cross-references are updated to align with the redesignations and new authorizations.
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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
- County, city, or Tribal health departments in the 50 counties or groups of counties with the highest infant mortality rates, which would gain funding and capacity to implement pilots.
- State health departments in states with centralized systems, which would coordinate pilot activities at scale.
- Hospitals, clinics, and community health organizations in high-need areas that partner with local health departments to deliver maternal and infant services.
- Public health researchers and HRSA staff who will evaluate program outcomes and generate evidence on effective interventions.
- At‑risk mothers and infants in high-mortality communities who receive targeted outreach, services, and supports.
Who Bears the Cost
- Grantee entities will bear administrative and program implementation costs, with up to 10% of grant funds allowed for evaluation.
- Local health departments and partner organizations may incur coordination and reporting burdens.
- Federal HRSA and the Secretary will bear administrative costs associated with grant management, reporting, and program evaluation.
Key Issues
The Core Tension
The central tension is whether to deploy scarce federal dollars into a targeted, evidence-building pilot program that could yield scalable, high-impact results, or to pursue broader, less-resourced reform that risks diluted impact and weaker evaluation.
The act concentrates funding and activity in the Nation’s highest-need areas, which improves the likelihood of meaningful results but raises questions about scalability and equity across other regions. The reliance on grant-based pilots creates concerns about long-term sustainability if federal support ends after five years, even as states and local entities may need to absorb ongoing costs to maintain successful interventions.
Additionally, while the program emphasizes coordination with existing public health efforts, there is potential for duplication or misalignment with state and local strategies if governance structures are not harmonized. Data quality, comparability across sites, and privacy considerations in collecting infant health information will also shape the reliability of the Secretary’s evaluation and the broader policy conclusions drawn from these pilots.
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