Birth Center Choice & Transparency Act (BCCTA)
Restoring true competition, informed consent, and parent-centered care in America’s maternity system.
As a mother who has experienced both the traditional hospital system and the care of midwives in birth centers and at home, I’ve seen firsthand the power of choice in maternal care. My last two births were attended by licensed midwives—one in a birth center, the other in the comfort of my own home. The difference wasn’t just in the setting—it was in the respect, transparency, and personalized care I received.
For too many families in urban communities, these options are hidden, underfunded, or left off insurance directories entirely. That’s not choice—that’s gatekeeping. Birth centers and midwifery care aren’t fringe alternatives—they’re safe, evidence-based models that deserve equal footing in our healthcare system.
This is why I’m championing the Birth Center Choice & Transparency Act—because every mother deserves to know her options, and every family deserves the freedom to choose what’s best for their birth story.
Legislative Objective
To guarantee that licensed freestanding birth centers are afforded equal visibility, nondiscriminatory insurance contracting, and fair reimbursement alongside hospitals and OB-GYN practices—empowering families to make fully informed decisions about where and how they give birth.
The Crisis in America’s Maternity System
Across the United States, and especially in areas like Chicago’s South Side, our maternity care system is failing families:
The U.S. has the highest maternal mortality rate among developed countries—and the highest cost.
In urban districts, access to safe, community-based, and culturally respectful prenatal care is disappearing as large hospital systems consolidate.
Many families don’t know that licensed birth centers—which offer midwife-led, lower-intervention care for low-risk pregnancies—are even an option.
Even when they do know, insurers often exclude these centers from networks, or bury them so deep in online directories that parents never find them.
Hospital-owned OB-GYNs frequently “steer” low-risk women away from birth centers, citing vague liability or safety concerns that are not evidence-based.
For families who want more personalized birth experiences, financial and information barriers often eliminate choice completely.
Consequence: A generation of working-class and minority families is trapped in a system that offers fewer choices, higher bills, and worse outcomes.
Why BCCTA Stands Apart
Zero new federal spending – leverages transparency, contract parity, and antitrust pressure instead of subsidies.
Hard protections against steering and exclusion, the two primary tactics hospitals use to marginalize birth centers.
Data-driven – public outcome dashboards shift debates from rhetoric to results.
Built-in enforcement – marketplace penalties (exchange participation limits) ensure insurer compliance without a new bureaucracy.
Faith & community friendly – protects culturally competent care models valued in many urban neighborhoods.
Why the BCCTA is a Necessary and Conservative Solution
The Birth Center Choice & Transparency Act (BCCTA) is not a government takeover of maternity care. It is a pro-family, pro-freedom policy that restores transparency, levels the playing field, and trusts parents to make informed decisions.
This legislation addresses four critical failures:
1. Lack of Transparency
Hospitals and insurers hide birth centers in their directories or don’t list them at all, despite being licensed, safe, and cost-effective.
What BCCTA Does:
Requires that birth centers appear in online directories alongside hospitals and OBs—clearly, equally, and visibly. It also mandates a "20-week notice"—a one-page, easy-to-understand document that shows expectant parents all birth options, c-section rates, and outcomes at nearby facilities.
2. Network Exclusion & Financial Discrimination
Many insurers don’t contract with birth centers—or they reimburse them at such low rates that centers can’t survive financially. This is corporate protectionism, not care-centered health policy.
What BCCTA Does:
Forces insurance companies to offer fair contracts to all licensed birth centers, and ensures payment rates are viable and based on the going rates for low-risk hospital births. Without spending a dollar of federal money, this policy creates space for innovation and competition.
3. Coercive "Risk" Labeling
Hospital-employed providers often classify patients as “too high risk” for a birth center without real medical evidence. These scare tactics limit autonomy and push patients into higher-cost settings.
What BCCTA Does:
Prevents blanket, non-clinical "risk" labels. Requires individualized documentation for any referral away from a birth center—just like any other referral between providers.
4. Hospital Monopolies
In many urban areas, a handful of hospital systems control 80% or more of maternity care, making it nearly impossible for independent birth centers to enter the market.
What BCCTA Does:
Triggers a federal antitrust review if any hospital system has over 40% of births in a region and is refusing to contract with birth centers. This ensures that competition can exist in the maternity space without illegal suppression.
How This Impacts Working-Class Families in IL-01
In areas like Englewood, Chatham, Roseland, and parts of Kankakee:
Maternity deserts have formed due to hospital closures, consolidation, and the lack of alternative providers.
Families are overwhelmed with medical debt from birth-related hospital stays.
There is little cultural competency, and women often report not feeling heard or respected during childbirth.
Meanwhile, birth centers have proven to offer equal or better outcomes at half the cost—but they are kept out of the system.
The BCCTA puts the power of decision-making back into the hands of mothers and families, not bureaucrats or monopolies.
This is Not Radical. This is Rational.
This bill doesn’t mandate birth centers. It doesn’t exclude hospitals. It doesn’t fund abortions or override state licensure.
It simply:
Ensures that every legal, licensed birth center gets a fair shot at being seen and paid.
Protects freedom of choice.
Holds monopolistic systems accountable.
Improves maternal care without expanding federal bureaucracy.
Why This Matters to Conservatives
This is limited government doing what it should: correcting a rigged system, enforcing fair play, and protecting freedom of choice in family life. It promotes:
Local entrepreneurship through community-led birth centers.
Parental rights by making sure families are informed.
Health freedom by increasing access to alternatives to the hospital-industrial complex.
Faith-based options by protecting religious and community-aligned centers.
Final Thought
The fight for better birth care is a fight for stronger families, lower costs, and true freedom. The Birth Center Choice & Transparency Act ensures that families—not hospital lobbyists—decide what’s best for them.
This bill is not about politics. It’s about making birth safe, dignified, and affordable for every American family—starting right here in Illinois' 1st Congressional District.
