Washington State Sets Highest Medicaid Birth Doula Reimbursement Rate in the Nation

March 18, 2024 9:49 am Published by

The state’s budget has allotted $200,000 to support the roll-out of public insurance reimbursement for birth doulas and established a $3,500 service cap.


MEDIA CONTACT: Elena M. Teare, elenat@openarmsps.org

SEATTLE, WA (March 7, 2024) – The 2024 Washington State budget has set the reimbursement rate for state-certified doulas providing services to pregnant people enrolled in Medicaid at $3,500, the highest in the nation. The budget also included an additional $200,000 to create a doula hub and referral system to support the roll-out throughout the state.

Washington is now on its way to joining twelve other states and Washington, D.C., in actively providing coverage for doula services through public health insurance. In 2022, Washington passed HB 1881, which created a new profession for doulas within the State’s Department of Health (DOH).

Aligned with advocacy efforts by the Doulas for All Coalition – of which Open Arms is a member– the budget ensures living wages for doula services. With a cap of $3,500 per birth, a fee-for-service model will set the rates for prenatal and postpartum visits and labor support. Currently, California offers full-spectrum doula coverage and raised its reimbursement rate from $1,500 to $3,100 in 2024, reflecting the national trend of raising doula Medicaid reimbursement rates.

Dila Perera, Executive Director of Open Arms, commented that “This incredible victory is thanks to the tireless advocacy of the Doulas for All Coalition and all the Black, Indigenous, Queer, and birth workers of color demanding not only equitable access to adequate perinatal care in their communities but a sustaining living wage for doulas doing this transformative work.”

“HB 1881 was only the first step. Now, we must do the hard work of ensuring the success of doula services under Medicaid by creating a system that can be navigated by patients and doulas alike,” continued Perera.

The DOH began accepting applications from doulas to receive their credentials in October of 2023, at no cost to applicants through June 30, 2025. As a voluntary certification, doulas only need to certify if they are planning to collect reimbursement for providing services to clients on public insurance. As an unregulated profession, doulas may practice with or without formal certification. There are three pathways to becoming a Washington State-certified birth doula: completing an education training program, demonstrating Ancestral Pathway Competencies, or submitting proof of out-of-state certification.


Doula care has been shown to improve birth outcomes, especially for Black and Indigenous birthing people. As the nation’s maternal health outcomes continue to worsen, demand for equitable access to support has galvanized states to utilize doulas through public insurance. Doula care is especially important for supporting maternal mental health, a leading cause of morbidity.


Founded in 1997, Open Arms is the first independent, community-based program in Washington State to provide comprehensive perinatal services to over four thousand economically marginalized families. We provide free support during pregnancy, birth, and early childhood with birth and community-based outreach doula services, lactation counseling, and social service referrals to over 500 families annually throughout the Puget Sound region.