Bills to improve Arkansas maternal health, change ballot initiative process head to Sanders’ desk

Above: Sen. Jimmy Hickey (left), R-Texarkana, votes present on House Bill 1427, cosponsored by Sen. Missy Irvin (center), R-Mountain View, on the Arkansas Senate floor on Tuesday, February 18, 2025. At right is Sen. Ricky Hill, R-Cabot. (Tess Vrbin/Arkansas Advocate)

Healthy Moms, Healthy Babies Act draws concerns about a statute of limitations; more proposed ballot initiative changes are still pending

By Tess Vrbin , Arkansas Advocate

Legislation that Arkansas lawmakers and Gov. Sarah Huckabee Sanders have said will improve the state’s maternal health care landscape moved closer to becoming law Tuesday.

Sanders also has the opportunity to sign into law two bills that would alter the citizen-led ballot initiative process after the Senate approved both despite bipartisan opposition.

On Feb. 6, Sanders announced that the Healthy Moms, Healthy Babies Act would improve low-income Arkansans’ access to health care during pregnancy and childbirth. Much of the legislation would alter the state’s Medicaid program by establishing presumptive Medicaid eligibility for pregnant Arkansans, offering reimbursements for doulas and community health workers, and establishing pregnancy-related Medicaid coverage for specific treatments.

Rep. Aaron Pilkington, R-Knoxville, and Sen. Missy Irvin, R-Mountain View, are sponsoring identical bills to create the policy: House Bill 1427 and Senate Bill 213.

HB 1427 passed the Senate with 24 votes for it and none against it Tuesday and will go to Sanders’ desk. SB 213 passed the House Public Health, Welfare and Labor Committee Tuesday, and the House is expected to give the bill final approval Wednesday.

The legislation has advanced with little dissent but occasionally with much debate over a clause on the final page that would make a child’s fifth birthday the statute of limitations for any actions against alleged medical injuries during birth.

Current law, which the two bills would amend, allows a minor or his or her legal guardian to “commence an action” on an alleged medical injury by the child’s 11th birthday or two years after the injury occurred, depending on which is later.

While no senators voted against either bill, six House Republicans voted against HB 1427, with some expressing concern about the statute of limitations.

Medical malpractice attorney Lamar Porter (left) speaks against a portion of the Healthy Moms, Healthy Babies Act before the Senate Public Health, Welfare and Labor Committee on Monday, February 17, 2025. At right is a sponsor of the legislation, Sen. Missy Irvin, R-Mountain View. (Tess Vrbin/Arkansas Advocate)

Little Rock attorneys Paul Byrd and Lamar Porter spoke against this clause before legislative committees voted to pass HB 1427. Byrd, a personal injury attorney, told House members last week that it would be difficult to determine any neurological damage to a child at all, let alone what caused it, before the age of five.

Porter is a medical malpractice attorney who has handled birth injury cases. He told the Senate Public Health, Welfare and Labor Committee on Monday that HB 1427 should not include the section with the statute of limitations.

“It is ironic to me that a bill designed to promote the health of moms and their babies has added to it a provision that potentially harms the legal rights of moms and babies,” Porter said.

He mentioned that the legislation does not specify whether the window for acceptable birth injury claims opens at the start of labor, the point of a pregnant individual’s admission to a hospital, or at another point in the “complicated process” of giving birth.

Only 34 hospitals in 23 of Arkansas’ 75 counties have labor and delivery units, and five maternity wards have closed since the onset of the COVID-19 pandemic in 2020, most recently in Newport.

The medical malpractice insurance required to cover the existing 11-year statute of limitations “completely contributes to those labor and delivery units being closed” and fosters the state’s difficulty recruiting and retaining obstetrician-gynecologists, Irvin said.

Arkansas has one of the highest maternal mortality rates in the nation, and the third-highest infant mortality rate, according to the Arkansas Center for Health Improvement.

Despite concerns about the statute of limitations from some committee members, including Sen. John Payton, R-Wilburn, HB 1427 passed the Senate committee with no audible dissent.

Senate Public Health, Welfare and Labor Committee members listen to discussion of the Healthy Moms, Healthy Babies Act on Monday, February 17, 2025. From left: Sen. Fredrick Love, D-Mabelvale; Sen. John Payton, R-Wilburn; and Sen. Clint Penzo, R-Springdale. (Tess Vrbin/Arkansas Advocate)

“I’m going to vote for this bill because I feel like it’s a treatment and it’s not the cure,” Payton said. “I would hope that somebody, maybe in [the Committee on] Insurance and Commerce, would work on the cure. I think it’s a sad state of affairs that we have to restrict the injured parties’ opportunity for recovery because the insurance companies are involved.”

Sen. Jimmy Hickey, R-Texarkana, voted present on both HB 1427 and SB 213 on the Senate floor. SB 213 passed the Senate with 30 votes for it, including all six Senate Democrats, and none against it.

Six House Republicans voted present on HB 1427 last week, while all 19 House Democrats and 67 House Republicans voted for it.

Ballot initiative legislation
All six Senate Democrats, plus Republican Sen. Bryan King of Green Forest, voted against House Bill 1221 and House Bill 1222, which next go to Sanders’ desk.

HB 1221 would clarify that the certification of ballot titles for initiatives, referenda and constitutional amendments as well as the signatures collected for those measures would only be valid for the next general election.

HB 1222 would expand the attorney general’s existing authority to reject a proposal if it conflicts with the U.S. Constitution or federal statutes. It would also prevent a sponsor from submitting more than one conflicting petition at the same time.

The bills’ Republican sponsors, Sen. Kim Hammer of Benton and Rep. David Ray of Maumelle, said HB 1222 is a response to supporters of proposed 2024 ballot measures submitting multiple petition language options for Attorney General Tim Griffin to approve or reject.

The supporters in question, Arkansas Citizens for Transparency, were among many groups that tried and failed to put changes to state law and the state Constitution on November’s ballot.

Arkansas is one of 24 states that allows for citizen-led initiatives, according to the National Conference of State Legislatures.

Hickey voted against HB 1221, and Sen. Alan Clark, R-Lonsdale, voted against HB 1222. No senators voted present on either bill.

Hammer is also sponsoring a fleet of Senate bills that opponents have called attacks on direct democracy last week and this week.

Two of those bills passed the Senate last week but did not receive the two-thirds majority vote necessary to pass their emergency clauses, which would allow them to go into effect immediately upon Sanders’ signature. The Senate subsequently passed motions to expunge the votes on the emergency clauses.

Senate Bill 209 would disqualify signatures collected by canvassers if the secretary of state finds “by a preponderance of evidence” that they violated state law collecting the signatures. Senate Bill 210 would require potential signers to read the ballot title of a petition or have it read aloud to them in the presence of a canvasser. It would also make it a misdemeanor for a canvasser to accept a signature from people who have not read the ballot title or had it read aloud to them in the presence of a canvasser.

Hammer said Tuesday that he will bring the two emergency clauses back to the Senate floor Monday since some senators are likely to be absent from the chamber this week due to inclement weather.

Emergency clauses need 24 votes to pass the Senate; HB 1221 has an emergency clause and received 25 votes. HB 1222 also received 25 votes but has no emergency clause.

Arkansas’ elections are overseen by the secretary of state, a position Hammer is seeking in 2026.

Current Secretary of State Cole Jester, who was appointed by Sanders and cannot run for the position, expressed support Monday for changes to the initiative petition process after claiming to have found “thousands of fraudulent signatures” in an election security review.

The Arkansas Advocate is a nonprofit, nonpartisan news organization dedicated to tough, fair daily reporting and investigative journalism that holds public officials accountable and focuses on the relationship between the lives of Arkansans and public policy.