Top image: Left to right: Sen. Deb Fischer (R-NE), Engage Founder Rachel Pearson, and Representative Lauren Underwood (D-IL)
The care agenda is at the center of Engage’s work, and two lawmakers most responsible for making progress on the care agenda are Sen. Deb Fischer and Representative Lauren Underwood. We were honored they joined the Summit for a hopeful conversation with Founder Rachel Pearson.
Engage recognized Sen. Fischer with a Public Service Award last December for making the 45S paid family leave tax credit permanent law and Engage partners with Rep. Underwood and her team on the Momnibus, her fourteen-bill maternal health package. Engage is actively working to spread the word about these benefits targeting small businesses, lower-wage earners, pregnant women and new moms.
At the State of the Majority Summit, the two joined Engage founder Rachel Pearson on stage for a conversation about that work, and about the gap both of them live with: Congress passes something good, and the people it was written for never hear about it. What follows are excerpts from their conversation.
“My inspiration for the paid family medical leave tax credit came from Nebraskans. I am back in the state just about every single weekend. Driving around the state to hear what’s on the minds of Nebraskans. Family issues, paid medical leave, and childcare are at the top of the list. So, in my office, we brainstormed about a way we could address this challenge without setting up a new government program. Currently, 27% of families that work for private businesses have paid leave. That means that three quarters don’t, and it’s mostly families that need that paid leave the most.
We looked at how we could address that in a practical way and make it work, especially for small businesses, mom and pop businesses on Main Street who maybe have two employees and really can’t offer a paid leave program because they don’t have the needed revenue coming in. It was an idea we came up with in 2014, and we finally got it over the finish line in 2015. Now, in federal law there is a credit that businesses can take advantage of. It’s wonderful passing a bill, but I want Nebraskans and all Americans to benefit from this law.”
The Moms Matter Act is a piece of the Momnibus designed to address the leading cause of preventable maternal death in this country, which is overdose and suicide. Many of our moms are in crisis, and so we are seeking to advance a bipartisan solution that would allow us to offer mental health, behavioral health, and substance use disorder services to moms during their pregnancy and postpartum periods. We need to have those providers readily accessible in every zip code if we are to be prepared to save moms’ lives.
We know that, for example, regarding suicide - if a pregnant or postpartum mom is expressing a suicide ideation, that time between an ideation and an attempt is much shorter than if they were not in that pregnancy or postpartum period, which means that there is a much shorter amount of time for life-saving intervention, which means that we need to have those providers readily accessible in every zip code if we’re going to be prepared to save moms’ lives. The whole Momnibus package was reintroduced in the House of Representatives just this past March with over 200 co-sponsors. We are moving towards the Senate, my friends, to get this done.
Left to right: Sen. Deb Fischer (R-NE) and Representative Lauren Underwood (D-IL)
Also in the Momnibus is the Perinatal Workforce Act, to make sure we have enough health care providers in all of our communities. If you’re in a rural state, like Sen. Fischer represents, or you are in an urban community, it doesn’t matter. Chances are you can’t find a provider of your choice if you are pregnant. You have a few choices before you. Do you want to be in a midwifery practice? Do you want to have a doula? And then after you have your baby, you might need some support with breastfeeding. Is there a lactation consultant available in your community? Chances are the answer is no for too many moms, and as a result, moms are dying. It’s not just that they’re having an unpleasant experience, or their birth experience isn’t what they expected. It is leading to preventable death.
What we are trying to do is grow and diversify this workforce, so that in 2026 all moms can have a choice of provider, they can get the care that they need in a timely way, and that they are no longer dying of these preventable causes. In the United States of America, this country with tremendous resources, we should be able to keep our moms alive, so that they live to see their child’s first birthday. And so those are just two examples of bills within the Momnibus that we’re working hard to advance.
There’s an emerging femtech boom. Everything from a period-tracking app to a Count Your Kicks app to an app that can connect you with a mental health provider if you’re in crisis. A lot of those great tools are operating on a subscription model, which means that our lowest income moms can’t afford that $20 a month to keep that app going throughout their pregnancy and postpartum period. That’s a bipartisan bill within our Momnibus package, and we’re trying to get it across the finish line.
There’s so many solutions, right? This is not a cancer moonshot, saving moms’ lives. We’re not out here trying to find a cure, and we’re 20 years away. No, no, this is just a question of, do we have the political will? I’m 39 years old. My friends are all having these beautiful babies, and they are the light of my life. And yet every time I hear one of my friends is expecting, I get that pause, because I have lost a friend to a preventable condition as a result of her pregnancy. And my vow, when I was elected, was no more. This cannot continue to happen, and so we’re working to advance this package in the Congress.
We saw a need out there in Nebraska, across this nation, for child care, not just available child care, but also affordable child care. We thought, okay, we need some flexibility in here, because rural Nebraska is different than what’s available in Omaha or what’s available in Lincoln. You have to be able to look at each community separately and figure out, okay, it’s not just child care centers, it’s not just going to be for profit or not for profit, it has to be able to include homes, it has to be able to include religious institutions, it has to be able to include grandma watching the children at home.
You’ve been able to have a healthy baby. You’ve been able to care for that child, but you also then are faced with a decision. Do you stay home and care for that child? Are you able to return to work, or go to work to help care for your entire family? We want to make it easier by offering flexibility, more options, so families can make a decision that’s going to work specifically for them.
One of my committees is the Appropriations Committee, and we were able to get a million dollars in funding for the Small Business Administration, specifically to develop outreach and education and information. They’re also working with the IRS to be able to get the word out on paid family leave. So we have government involved, but I’m a Republican. Government’s not the answer for everything, so I challenge all of you in this room to become involved and really help us with this outreach. It would be extremely helpful if you know of good stories to tell, success stories where something has been used. That’s how we get people motivated. That’s how we build our coalitions. That’s how we gather stakeholders.
We have been successful using the appropriations process of unlocking over $250 million of new Momnibus funding to support the programs in this bill, and those dollars are out on the street. If you are connected with a nonprofit organization that’s doing important community-based work designed to end preventable maternal death, chances are you are eligible for some funding, and we would love for you to apply and to use it to save moms’ lives. We have a newsletter that we publish every month from the Black Maternal Health Caucus, called the Momnibus Memo, where we are socializing these funding opportunities.
Please help us by reaching out to Democratic and Republican representatives and senators and asking them to co-sponsor the Momnibus. We can get this done, and it is broadly popular. This is a nonpartisan issue. What we need is help prioritizing it on the legislative agenda, so that we can just get it across the finish line this year. I have every faith in the strength of your power as advocates, and we are just really inviting you to join us in this fight. Rachel closed on the simplest possible note: “These two women are extraordinary.”
