Arkansas now requires insurers to cover birthing center births, at same cost as a hospital

A new law changes how births get covered

Arkansas Act 866 took effect Jan. 1, 2026, and it changes what health insurers must pay for.

The law requires state-regulated insurance plans, Medicaid, and the Arkansas Health and Opportunity for Me (ARHOME) program to cover births at licensed birthing centers.

The catch: that coverage must match what insurers pay for hospital births.

Copays, deductibles, and out-of-pocket costs cannot run higher than they would for a hospital delivery.

Not every plan falls under this law

This law does not apply to everyone. Self-insured employer plans fall under federal law, known as ERISA, and state insurance rules do not touch them.

That means workers whose employers self-fund their health coverage may not see any change. If you are unsure which kind of plan you have, check with your employer or insurance provider.

Knowing whether your plan is state-regulated or self-insured is the first step to understanding what this law means for you.

Birthing centers serve lower-risk pregnancies

Licensed birthing centers are not for every pregnancy. They serve women with low-risk pregnancies who expect uncomplicated deliveries.

High-risk situations, including preterm labor or preeclampsia, still require hospital care. The Arkansas Department of Health licenses these centers and holds them to state safety standards.

Each center must also have a transfer agreement with a nearby hospital in case something goes wrong during labor. That backup plan is required, not optional.

The bill passed with almost no opposition

Rep. Mary Bentley and Sen. Dave Wallace, both Republicans, sponsored the bill. The Arkansas House passed it 91 to 1 on April 2, 2025.

The Senate followed on April 14, passing it 31 to 1. Gov. Sarah Sanders then signed it into law as Act 866.

That kind of near-unanimous vote is rare in any legislature, and it signals broad agreement that Arkansas needed to act on maternal health.

Arkansas ranks among the worst states for maternal health

The numbers behind this law are hard to ignore. Arkansas has one of the highest maternal mortality rates in the country.

It also holds the third-highest infant mortality rate nationally. The March of Dimes gave the state an “F” grade on its 2024 maternal health report card.

On top of that, about 50.7% of Arkansas counties qualify as maternity care deserts, meaning they have no birthing hospital, birth center, or obstetric provider at all.

Rural hospitals keep closing maternity wards

An Arkansas Center for Health Improvement report on maternal health care highlighted the strain on rural communities. As of May 2025, only 33 hospitals in Arkansas still offer labor and delivery services.

Seven hospitals shut down their obstetric units since 2019, with four of those closures tied to staffing shortages and three tied to financial problems.

That leaves 60% of the state’s rural hospitals without labor and delivery care. For many Arkansas women, the nearest place to give birth keeps getting farther away.

Birthing centers could help fill that void

Supporters say Act 866 could open the door to lower-cost maternity care, especially in rural areas where hospital options have dried up.

Births at licensed birthing centers generally cost less than hospital deliveries for uncomplicated pregnancies. But the law’s real-world impact depends on how many licensed birthing centers actually operate in Arkansas.

As of early 2026, the number of active freestanding licensed centers in the state remains unclear. More centers would need to open for the law to reach its full potential.

Act 866 was one of several bills that passed

Act 866 did not arrive alone. The 2025 Arkansas legislature passed several maternal health bills in the same session.

Act 138 lets certified nurse midwives admit and discharge patients from hospitals. Act 627 requires insurance plans to cover breastfeeding and lactation consultant services.

Act 868 creates a maternal outcomes management system within the Department of Health to track data and improve care. Together, these bills make up Arkansas’s biggest push on maternal health in years.

A bigger investment anchored the whole effort

Gov. Sanders signed the Healthy Moms, Healthy Babies Act, listed as Act 124, in February 2025. The law represents a $45.3 million annual investment in maternal and infant health.

It set up presumptive Medicaid eligibility so pregnant women can get prenatal care while their applications are still being processed.

For the first time, doulas and community health workers can bill Medicaid for their services. That shift alone could expand who gets care and how fast they get it.

Medicaid pays for nearly half of state births

Medicaid covers about 41% of births in Arkansas, making it a central player in how the state delivers maternal care. Health plans often pay rural hospitals less than the actual cost of running a maternity ward.

The Healthy Moms, Healthy Babies Act addressed that by raising Medicaid reimbursement rates for deliveries and prenatal visits by 70%.

Arkansas also secured about $17 million in federal funding over 10 years through the Transforming Maternal Health Model grant. That money is meant to help stretch these reforms further.

One major gap still leaves mothers at risk

Arkansas remains the only state in the country that has not extended postpartum Medicaid coverage beyond 60 days after birth. Every other state has adopted the federal option to extend that coverage to 12 months.

A bill to fix that, HB1004, passed the Arkansas House 71 to 10 but died in a Senate committee in April 2025.

Reports show that 44% of postpartum mothers on Medicaid lost their coverage in the last quarter of 2025, leaving many women uninsured just weeks after giving birth.

The work in Arkansas is far from finished

Rep. Aaron Pilkington said he plans to file another bill to extend postpartum Medicaid coverage in the 2027 legislative session.

Meanwhile, the University of Arkansas for Medical Sciences (UAMS) received a $4 million federal grant to bring maternal health services to rural Ashley and Union counties starting in 2026.

The state also launched mobile health units to deliver prenatal and postpartum care in underserved areas.

Act 866 is now on the books, but supporters and critics alike say it is only one piece of a much larger problem Arkansas must solve.

This article was created with AI assistance and human editing.

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