'Momnibus' bill to improve maternal health passes on final day, after being attached to another bill to avoid floor fight on abortion

Rep. Kim Moser presents SB 74
to the state House (Ky. LRC photo)

By Melissa Patrick and Al Cross
Kentucky Health News

On the last day of the 2024 legislative session, a bipartisan bill aimed at improving Kentucky's dismal maternal-mortality rate was finally passed, after parliamentary maneuvering to avoid divisive issues.

Provisions of House Bill 10, known as the "Momnibus" bill for its varied approach, were added to Senate Bill 74, a bill to require analysis of child and maternal fatalities and add reporting requirements.

The Momnibus bill, sponsored by Republican Rep. Kim Moser of Taylor Mill, came from an informal, bipartsan House-Senate workgroup of female legislators who tackled a big problem: the nation's second highest rate of death of mothers in the year following childbirth. 

From that came a multifaceted bill that ensures access to health-insurance coverage for pregnant women by adding pregnancy to the list of exceptions for enrollment outside the normal open-enrollment period, and several other things.

It establishes a mental-health hotline called Lifeline for Moms that allows providers access to an immediate mental-health consultation for a mother in need; expands the Health Access Nurturing Development Services (HANDS) home-visiation program and lets it be available up to three years after birth; covers lactation consultation and needed equipment to encourage breastfeeding; and will educate mothers on the benefits of safe sleep for infants. These services would also be available via telehealth.

Democratic Sen. Cassie Chambers Armstrong of Louisville told the Senate that Moser "brought together a bicameral, bipartisan group of women legislators and "This is a truly great piece of legislation that will absolutely save lives."

The final bill dropped controversial language that added by a Senate committee. It would have required all hospitals, birthing centers and midwives to refer patients to a perinatal palliative-care program if the patient had a prenatal diagnosis that indicated a "baby" might die before or after birth. Kentucky abortion law does not allow for the termination of such pregnancies, though it is considered a standard of care for a nonviable pregnancy.

Abortion prompted the parliamentary maneuvering. Democratic senators filed floor amendments to Moser's HB 10 to change "baby" to "fetus"; let a physician terminate a pregnancy if it is complicated by a fatal fetal anomaly, or in the good-faith belief that the pregnancy was caused by rape or incest. To avoid a Senate floor fight over the issue, Moser looked for another vehicle.

She found SB 74, sponsored by Sen. Shelley Funke Frommeyer, R-Alexandria, with an apt title. "I saw 'An act relating to maternal health'," she recalled. "It was germane, and apropos. . . . It works really well with the underlying bill."

Funke Frommyer said SB 74 was viewed favorbaly by a House committee, but didn't get a floor vote before legislators recessed to give Gov. Andy Beshear time to veto legislation and give them time to override his vetoes. Moser said the House considered the bill safe from a veto because it was non-controversial.

The original parts of SB 74 require the Cabinet for Health and Family Services to publish a report on its website for the most recent five years of available data on the number and types of delivery procedures for pregnancy by hospital.  It also has cleanup language for a number of health-cabinet programs.

The revised, combined bill passed the House 91-1, with Rep. Courtney Gilbert, R-Hodgenville, voting against it. On the House floor, Rep. Lindsey Burke, D-Lexington, praised the bill and Moser's work.

 "I have never been more delighted, proud or excited to vote for any single piece of legislation," Burke said. "It is a gift to the families of the commonwealth. I thank her for her hard work." 

The Senate agreed to the changes on a 29-5-2 vote, with Republicans Greg Elkins of Winchester, Jimmy Higdon of Lebanon, Chris McDaniel of Ryland Heights, Robby Mills of Henderson and Stephen West of Paris voting no and Republicans Donald Douglas of Nicholasville and Adrienne Southworth of Lawrenceburg passing. Republican John Schickel was absent.

Sen. Amanda Mays Bledsoe, R-Lexington, told the Senate, "I thought it was fantastic to have a Kentucky-crafted legislation that looked at solutions for us and not other states. . . . I just complement the bill sponsors and members of that working group for the good work."

Abortion did hit the Senate floor late in the day, as Sen. David Yates, D-Louisville, tried to bring up his SB 99, which would have added rape and incest exceptions to state abortion laws. Senate leaders ruled his action out of order, and when he appealed the ruling, senators upheld it largely along party lines.