The state now guarantees full medical care for pregnant women, including 12 months of postpartum coverage, regardless of immigration status. Specialists outlined the scope of Medi-Cal, CalAIM, and Family PACT during a briefing organized by ACoM.
Amid federal cutbacks to social healthcare systems across the country, backed by Donald Trump and his bloc,California has emerged as the exception to a rule that is affecting the rest of the United States. The state maintains its commitment to providing comprehensive medical care to all pregnant women.
A few weeks ago, it was announced that all individuals in pregnancy, regardless of immigration status, will be able to receive care through the Medi-Cal program and will also have full coverage for up to 12 months after giving birth. This was the central focus of the conference “Amid National Health Cutbacks, California Preserves Full Maternal Coverage”, organized by American Community Media (ACoM), where several health system specialists participated.
Expansion of Medi-Cal and New Benefits
Raquel Saunders, Chief of the Medi-Cal Benefits and Legislation Section at DHCS, stated that in response to concerns among migrant communities about federal changes, California’s position must be made clear: “All pregnant people, regardless of their immigration status, are eligible for full-scope Medi-Cal services.” She reaffirmed that this coverage includes dental care, mental health services, prenatal checkups, and postpartum depression treatment.
Saunders explained that Medi-Cal has expanded its services in recent years, strengthening maternal care through CalAIM (California Advancing and Innovating Medi-Cal) and the Birth & Care Pathway, which offer more provider options, languages, and cultural preferences. She also highlighted informational tools such as the prenatal services brochure and the guides on maternal support teams, which help distinguish between obstetricians, midwives, and doulas.
Growth of Doula Services
One of the central points was the expansion of the doula benefit, available since January 2023. “As of November 2025, DHCS has registered 1,098 doula providers,” Saunders noted. These services include emotional and physical support during pregnancy, labor, and postpartum; assistance during pregnancy loss; lactation guidance; birth planning; and referral to community resources.
Regarding access, she emphasized that no prior authorization is required for most visits and that a statewide doula directory is updated monthly, with filters by county, language, and specialty. She also reminded attendees that members enrolled in Medi-Cal Managed Care must coordinate with their health plan.
Saunders added that California recognizes two types of midwives: certified and licensed. Both can attend low-risk pregnancies in hospitals, birth centers, or homes. “In March 2024, Medi-Cal policies were renewed to ensure their full inclusion,” she said.
The official also stressed the importance of CalAIM’s integrated social services, which address key determinants such as housing, food, and transportation, elements that are essential for maternal health.
Family PACT: Family Planning Without Immigration Barriers
Sarah Gilbert, Chief of the Office of Family Planning at the Department of Health Care Services, explained that one of the pillars to strengthen access is Family PACT.
“Family PACT serves California residents with incomes below 200% of the federal poverty level who have a medical need for family planning services and are uninsured or face barriers to accessing care,” she said.
For Gilbert, the most notable aspect of the program is its accessibility: “You only need to live in California. Enrollment is easy and can be completed at any participating clinic on the same day services are needed. You can also apply online at familypact.org,” she explained.
The program offers education and counseling on family planning; contraceptive methods such as implants, IUDs, pills, and condoms; as well as testing and treatment for STIs and screenings for cervical cancer and other diseases.
Gilbert emphasized that services are free and confidential, no immigration questions are asked, and enrollment does not affect public charge status: “This ensures that people can seek the services they need without fear.”
The Role of Midwives in Maternal Health
Eva Goodfriend-Reaño, a certified nurse-midwife at Alameda Health System, highlighted that midwives attend 13% of vaginal births in the state. Most work in hospitals, but many also practice in birth centers and homes.
She described their work as comprehensive care: “We care for people before they become pregnant, throughout their pregnancy, during birth, and in the postpartum period.” In some settings, midwives can also care for newborns during the first weeks and refer them to pediatric care when needed.
Goodfriend-Reaño emphasized the impact of the extended coverage: “There has been an increase in postpartum depression and anxiety. Now, with this coverage, if someone is experiencing postpartum depression, they can continue seeing a midwife,” she said.