Congress Strengthens Maternal Mortality Program, Administration Seeks Elimination

Why It Matters

A new Congressional Research Service report on federal support for maternal mortality review committees lays out a direct conflict: Congress recently reauthorized and expanded funding for the program, while the Trump administration has proposed eliminating it.

Maternal mortality review committees are the primary tool the U.S. uses to understand why pregnant and postpartum women die. These multidisciplinary, state-level bodies review every death occurring during pregnancy or within one year postpartum, drawing on clinical records, vital statistics, and even police reports to build a complete picture of each case. The CRS report describes them as the "gold standard" for identifying and reviewing pregnancy-associated deaths.

The federal program supporting these committees, CDC's ERASE MM (Enhancing Reviews and Surveillance to Eliminate Maternal Mortality), currently operates in 46 states, four U.S. territories, and two freely associated states. Without it, states lose the standardized tools, technical assistance, and funding that make maternal health surveillance consistent and actionable across jurisdictions.

The tension at the center of this report is straightforward: Congress has moved in one direction, the administration in another.

The Big Picture

Maternal mortality review committees have existed in varying forms since the 1930s, but federal support was not formally codified until the Preventing Maternal Deaths Act of 2018 (P.L. 115-344). That law amended Section 317K of the Public Health Service Act to authorize the Department of Health and Human Services, acting through the CDC, to support the development or continuation of these committees in collaboration with states, territories, Indian tribes, and tribal organizations.

The law also authorized $58 million in annual discretionary appropriations across all Section 317K activities from fiscal year 2019 through fiscal year 2023 and led directly to the creation of the ERASE MM program, which provides grants to entities that coordinate or manage the committees.

Funding grew steadily after that. Appropriations under CDC's Safe Motherhood and Infant Health budget activity rose from $58 million in fiscal years 2019 and 2020, to $63 million in fiscal year 2021, to $83 million in fiscal year 2022, to $108 million in fiscal year 2023, reaching $110.5 million in fiscal years 2024 and 2025, and $113.5 million in fiscal year 2026.

Congress reinforced that trajectory earlier this year. The Consolidated Appropriations Act, 2026 (P.L. 119-75) reauthorized Section 317K, raised the annual funding authorization from $58 million to $100 million for fiscal years 2026 through 2030, and strengthened several program requirements. Among the changes: a new directive requiring HHS, in consultation with the Health Resources and Services Administration, to disseminate best practices for preventing maternal mortality and morbidity to hospitals, professional societies, and perinatal quality collaboratives at least once per fiscal year.

Additional legislation pending in the 119th Congress, H.R. 8080 and S. 4187, would go further still. Both bills propose authorizing an additional $10 million annually from fiscal year 2027 through fiscal year 2031 for grants to promote community engagement in the committees, reserving not less than $1.5 million for Indian tribes and tribal and Urban Indian organizations, and expanding the committees' scope to include investigations of severe maternal morbidity.

Committees and Budget Proposals

Against that legislative backdrop, HHS has proposed eliminating the Safe Motherhood and Infant Health portfolio in both its fiscal year 2026 and fiscal year 2027 budget proposals. That portfolio is the funding vehicle for ERASE MM and the broader set of maternal death prevention activities authorized under Section 317K.

The CRS report notes that policymakers may need to examine the extent to which the HHS reorganization and budget proposals could affect the program and the specific agencies named in statute. Both the CDC and HRSA are identified by name in the law. If either agency is restructured or has its authorities altered through reorganization, the statutory framework for federal maternal mortality programs could be disrupted even without explicit legislative changes.

The report also flags a data challenge that runs through all of this. Measuring maternal mortality accurately is an ongoing problem. Vital statistics data alone can identify trends and disparities, but the committees go further, accessing both clinical and nonclinical information and triangulating those data to understand the full circumstances and causes linked to pregnancy-related deaths. They also recommend prevention strategies informed by and tailored to specific local contexts, something aggregate national data cannot do.

If ERASE MM funding is eliminated, states would lose the standardized framework, common data platform, and direct grant support that make maternal mortality data collection consistent and comparable across jurisdictions.

Political Stakes

For the administration, the proposed elimination of the Safe Motherhood portfolio creates a visible tension with its stated interest in maternal health. Eliminating a program that Congress just reauthorized and expanded, with bipartisan support, puts HHS in a position of working against a recently enacted law.

For Republicans in Congress, the reauthorization passed as part of the Consolidated Appropriations Act, 2026, meaning members who voted for that package voted to strengthen the program. Any move to defund it through the appropriations process would require revisiting that position.

For Democrats, the CRS report provides a clear legislative record to draw on. The funding history, the statutory requirements, and the explicit conflict between P.L. 119-75 and the administration's budget proposals offer concrete material for oversight and appropriations fights.

For the public, the stakes are direct. The U.S. continues to have high maternal death rates relative to peer nations, with persistent disparities across demographic groups. The committees are the mechanism designed to understand and reduce those deaths. Defunding the infrastructure that supports them would affect maternal health surveillance at the state level across most of the country.

The Bottom Line

Congress passed a law this year raising the funding authorization for maternal mortality review committees to $100 million annually through 2030 and strengthening the program's requirements. The administration has proposed eliminating the program's entire funding portfolio for two consecutive budget years.

The CRS report frames the question directly for lawmakers: they may need to determine whether separate funding allocations or specific agency directives are necessary to protect the committees and the other maternal, infant, and child health activities authorized under Section 317K, particularly given the ongoing HHS reorganization. The gap between what Congress authorized and what the administration has proposed is not subtle, and the CRS is signaling that Congress may need to act again to ensure the law it just passed is actually implemented.

Access the Legis1 platform for comprehensive political news, data, and insights.