Vermont H 40: An act relating to licensure of freestanding birth centers

Bill Text

BILL AS INTRODUCED H.40
2025 Page 1 of 10

VT LEG #378788 v.1
H.40 1
Introduced by Representatives Chapin of East Montpelier, Arsenault of 2
Williston, Burke of Brattleboro, Cordes of Bristol, Critchlow of 3
Colchester, Demar of Enosburgh, Goldman of Rockingham, 4
Graning of Jericho, Logan of Burlington, McCann of 5
Montpelier, Mrowicki of Putney, Pouech of Hinesburg, and 6
Priestley of Bradford 7
Referred to Committee on 8
Date: 9
Subject: Health; health care facilities; birth centers; certificate of need; health 10
insurance; Medicaid 11
Statement of purpose of bill as introduced: This bill proposes to establish a 12
licensing structure for freestanding birth centers and to exempt birth centers 13
from certificate of need review. It would also require prenatal, maternity, 14
postpartum, and newborn coverage under health insurance plans and Medicaid 15
to include birth center services. 16
An act relating to licensure of freestanding birth centers 17
It is hereby enacted by the General Assembly of the State of Vermont: 18
Sec. 1. PURPOSES 19
(a) The purposes of this act are: 20

BILL AS INTRODUCED H.40
2025 Page 2 of 10

VT LEG #378788 v.1
(1) to reduce health care costs; 1
(2) to protect women’s access to prenatal, maternity, birthing, 2
postpartum, and newborn care services; and 3
(3) to ensure women have a choice in how and where they give birth. 4
(b) This act would achieve those purposes by: 5
(1) removing the certificate of need requirement for establishing a 6
freestanding birth center; and 7
(2) licensing and regulating birth centers. 8
Sec. 2. FINDINGS 9
The General Assembly finds that: 10
(1) Vermonters value reproductive rights and equity in health care 11
choices, including the right to give birth in the setting of one’s choice. 12
(2) In Vermont, the only birthing settings that women and families 13
currently have are to have their babies in a hospital or at home. 14
(3) Vermont is one of the last states to ensure access to freestanding 15
birth centers. 16
(4) The American College of Obstetricians and Gynecologists, the 17
American Academy of Pediatrics, and the Society for Maternal-Fetal Medicine 18
all endorse the birth center model of care as a safe and evidence-based option 19
for individuals with low-risk pregnancies. 20

BILL AS INTRODUCED H.40
2025 Page 3 of 10

VT LEG #378788 v.1
(5) In 2018, the Centers for Medicare and Medicaid Services issued a 1
report on the “Strong Start for Mothers and Newborns” initiative, which found 2
that rates of preterm birth, low birthweight, and cesarean section were lower 3
among Medicaid participants who received care and delivered their babies in a 4
freestanding birth center than those who delivered in a hospital or other non-5
birth center setting. In addition to better outcomes, the report also found that 6
costs for Medicaid participants who delivered at a birth center were more than 7
$2,000.00 lower per mother-infant pair during birth and the following year 8
than for the Medicaid participants who did not use a birth center. 9
(6) Birth centers are safe, supportive settings in which Vermonters can 10
receive prenatal, maternity, birthing, postpartum, and newborn care services. 11
Nationally, they have demonstrated better outcomes and reduced costs 12
compared with other birthing settings. 13
Sec. 3. 18 V.S.A. § 9435(a) is amended to read: 14
(a) Excluded from this subchapter are offices of physicians, dentists, or 15
other practitioners of the healing arts, meaning the physical places that are 16
occupied by such providers on a regular basis in which such providers perform 17
the range of diagnostic and treatment services usually performed by such 18
providers on an outpatient basis unless they are subject to review under 19
subdivision 9434(a)(4) of this title. The exclusion provisions of this subsection 20
shall also apply to birth centers licensed pursuant to chapter 53 of this title. 21

BILL AS INTRODUCED H.40
2025 Page 4 of 10

VT LEG #378788 v.1
Sec. 4. 18 V.S.A. chapter 53 is added to read: 1
CHAPTER 53. BIRTH CENTER LICENSING 2
§ 2351. DEFINITION 3
As used in this chapter, “birth center” means a facility: 4
(1) that is not a hospital or part of a hospital; 5
(2) at which births are planned to occur away from the pregnant 6
individual’s residence following a low-risk pregnancy; and 7
(3) that provides prenatal, labor and delivery, or postpartum care, or a 8
combination of these, as well as other related services in accordance with the 9
scopes of practice of the health care professionals practicing at the birth center. 10
§ 2352. LICENSE 11
No person shall establish, maintain, or operate a birth center in this State 12
without first obtaining a license for the birth center in accordance with this 13
chapter. 14
§ 2353. APPLICATION; FEE 15
(a) An application for licensure of a birth center shall be made to the 16
Department of Health on forms provided by the Department and shall include 17
all information required by the Department. 18
(b