Doula Bill HB0295 Rolled to January 2026

First, I want to thank everyone for the countless letters and phone called made to legislators about this bill. You made a difference.

If you are not aware of the bill...let me catch you up a little.

In 2023 the word "doula" was entered into legislation officially and a Doula Services Advisory Committee of 3 doulas was started to study the doula profession for 18 months. In October 2023 the group started meeting virtually and included doulas Savannah, Teri, and Allison along with state officials.

In February 2024 Terri left the committee. Then, in April Savannah left the committee. This left Allison as the only doula on the committee to represent the entire doula population in TN. Funny thing is, Allison lives in North Carolina, not TN. Weird isn't it. You might ask how a doula from NC was chosen when many other doulas applied from TN. I, myself, applied to join the committee, but I was told that I was over qualified since I had been a doula for 30 years. I did not know you could be over qualified to be on a committee to teach legislation about our doula profession.

Well, faithful Allison continued to be the only doula on the committee for several months and she did make every monthly meeting. Finally, in July 2024 they appointed Kaila to be a second doula on the committee. Due to her schedule, she was only able to attend a couple meetings before the 18 months was over.

In October 2024 Zarema was finally added as the 3rd doula, but due to her schedule she could not attend any meetings.

In December 2024 and January 2025 there were no meetings and a final meeting was held in February 2025. They decided to have one more meeting in March 2025 to finish out their report. You can actually watch a recording of any of these meetings here.

You can also read the final Doula Services Advisory Committee Report by clicking here.

While all of this was going on we were watching legislation about doula services. A new bill was introduced in 2024, but it was killed in legislation.

In January 2025 the same bill came back from 2024 and we were concerned with the language. We first met with Healthy and Free TN who wrote the bill with Senator Lamar from Memphis. We told them about our concerns and they told us not to worry about it.

Our next step was to meet with Senator Lamar on February 4, 2025 who dismissed our concerns. Our next step was to talk to more legislators, like Representative Love, about our concerns. We then attended Senator Lamar's Day on The Hill. We got very concerned when she paraded legislators in front of us and told them that her bill would only cost $300,000 from the state, but would next $1 million from the doulas in the first year. This was very concerning to us.

We made another appointment with Senator Lamar March 4th to talk with her again. We asked her to change the language in the bill as it would be harmful to our profession. We then gave her our proposed language. She refused to change anything and told us that she was pushing the bill through. She also told us that insurance required a state doula board before they could be paid by insurance.

I knew this was not true since I am already a provider through Tricare. I get paid for my doula services and I am not under a state board. I also wanted to do a little fact checking, so I arranged to meet with a TennCare official. I asked them about a state board being required to pay doulas. They confirmed that a verification process was needed, but not a state board. That gave me the information to move forward with our view of the bill.

So, we decided to attend the committee meetings to voice our concerns and talk with more legislators. The Senators we talked to told us that they were informed that we wrote the bill and were behind it. We were shocked and told them that we opposed it from the beginning.

Then, on March 10th, TennCare reimbursement for doula services was removed from the bill. This bill was no longer about insurance paying for doulas. It was only about creating a state controlled doula board. We decided that we had to stop this.

The main points are:

1. TennCare verbiage was removed from the bill by amendment.

2. This is no longer about getting doulas paid through insurance. 

3. This bill is now about making a state doula board to control and tax us. 

4. They say it will be optional, but no board in TN is optional. You are a member and pay or you can't work in that profession in TN. It is a state law that all boards are self sustaining. This means that even if it was optional one year, the state commissioner would make it mandatory for all doulas the second year, so that the board fees are covered as required by the law.

5. You don't need a state board to reimburse doulas through insurance. You need verification, not state certification. We checked with TennCare and other insurances who verified this fact. Almost all of the other states in the nation have created a verification process without making a doula board.

You might be wondering if we are against Tenncare paying for doula services. No, we do not oppose reimbursement from TennCare. However, this bill was amended to remove any language regarding TennCare. Instead, an amendment was added to create a Doula Board—without specifying that participation would be voluntary.

If we let this bill go through, it will create a state board. Additionally, the fiscal note for establishing this board, which would regulate doulas (who are non-medical professionals), comes at a significant cost of $281,000. As with all health-related boards and councils, administrative costs must be covered by the fees of those being licensed, certified, or verified. The fiscal note estimates that approximately 170 doulas would participate in Tennessee, translating to a biennial cost of roughly $1,653 per doula. This financial burden is neither feasible nor sustainable and would be detrimental to the doula community.

The final committee meeting was April 2nd and Representative Love asked to have the bill rolled to January 2026. It did not come up for a vote this year and that will happen next year.

Now, you might be wondering if that is the end.... No, it is still a fight that will have to be continued in 2026. In TN legislation session lasts for 2 years. So, if a bill is not finished through the process, it can move to completion in the second year.

What is the plan? We are going to keep meeting with representatives about these points. We will need your help to do that with us starting in January so that it is fresh in their minds that we oppose it. Rep Love hopes that the committee will forget and vote yes on the bill if we wait til January. We will need your help visiting legislators in January 2026. Any relationships you start now would be helpful as well. I would like to keep everyone here on the alert list to help.

We need to work together as doulas if we want to stop a creation of a state board. We can not do this alone. Please spread the word to other doulas so we can hit them hard in January. We have 8 months to educate doulas across the state and get them united in the fight against this bill. Please keep talking about it and sharing it.