Medicaid Would Cover Home Visits Under Nadeau Proposal

WASHINGTON, D.C.— Councilmember Brianne K. Nadeau, D-Ward 1, introduced legislation to add evidence-based home visiting services to what’s covered by Medicaid.

The proposed legislation, B25-0321-Home Visiting Services Reimbursement Act of 2023, would require D.C.’s Medicaid insurance program to cover home visitation services such as postpartum care for new mothers, diet consultation, nutrition education, alcohol and substance abuse screening and other services that are proven to be effective. The extension of coverage would also apply to the Immigrant Children’s Program and the DC Healthcare Alliance Program.

Councilmembers Janeese Lewis George, Robert White, Zachary Parker, and Charles Allen co-introduced the bill with Nadeau. It was referred to the Council’s Committee on Health, with a request for comments from the Committee on Business and Economic Development.

“As a mom of 2 little ones, I know firsthand how overwhelming it is to bring home a new baby. Our home visiting programs ensure that new mothers and the parents of young children and toddlers will have access to services that are critical to mothers’ health and the health and development of their children,” Nadeau said. “These evidence-based services help improve both health and education outcomes for our children.”

At least 20 states’ Medicaid plans include home visitation coverage. Research shows supporting new mothers and mothers of young children has short- and long-term impacts that help families provide a nurturing and healthy environment for their kids.

Children’s experiences up to the age of 5 are critical for their foundational development. During this time period, they develop cognitive, language and literacy, emotional, and reasoning capabilities. When infants and young children deal with poverty or other toxic stressors, it has a detrimental impact on both their short- and long-term development and leads to lifelong health disparities.

Evidence-based home visiting programs that engage expectant parents and provide parental coaching and guidance in addition to helping them access other professionals and services are among the most effective interventions available to alleviate the stressors of poverty. For example, Nurse-Family Partnership, which Nadeau brought to the District through previous legislation, provides home visiting services to first-time mothers and has found that their services have resulted in children of program participants being 48 percent less likely to suffer child abuse and neglect and 67 percent less likely to experience behavioral and intellectual problems at age 6, while mothers who participated in the program experienced a 35 percent reduction in pregnancy hypertensive disorders.

Nadeau said adding home visiting services to Medicaid coverage would make it available to more parents. Medicaid is the District’s insurance plan for low-income residents; the District generally covers 30 percent of the cost for all services with the federal government covering the other 70 percent.

“Each year during our budget process we hear advocacy for more funding for home visiting programs,” Nadeau said. “Accessing Medicaid dollars allows us to stretch local funds, to ensure that all mothers in the District can benefit from these services.”


Full bill text


Home visiting programs give new moms services critical to their health and the health and development of their children. This month the Council passed my Home Visiting Services Reimbursement Act, which gives access to these services to families on Medicaid.
Councilmember Nadeau fought hard for the excluded worker payouts, working with Councilmembers Henderson and Lewis George

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