WFS 2025 Shift the South Legislative Recap

LEGISLATIVE RECAP 2025

Introduction and Summary The Women’s Foundation of the South (WFS) is not just a foundation—it is a movement. We exist to build the health, wealth, and power of women, girls, and gender-expansive people of color in the U.S. South as a blueprint for a flourishing future. The South has always been ground zero for Americaʼs greatest transformations—and yet, generation after generation, the inequalities remain stubbornly intact. Still, the South is where the roots of transformation run deepest, and where the soil must shift if the harvest of justice is to ever come.

To alter the trajectory of the nation, we must first alter the South.

The truth is trenchant: Southern legislatures are where life, death, and dignity are decided. In 2025 alone, more than 2,500 laws were signed across Alabama, Arkansas, Georgia, Louisiana, Mississippi, Tennessee, and Texas. Our analysis surfaces 15 wins, 7 setbacks, and 2 mixed results.

This legislative recap focuses on four battle lines: maternal and infant health, gender-affirming care, economic security, and civic participation.

With Maternal & Infant Health, across the South we experienced politics over patients/patient-care.

Even still there were gains: Medicaid presumptive eligibility for pregnant women in Alabama, Arkansas, and Mississippi. Doula coverage in Louisiana and Arkansas. Lactation support in Texas.

But Tennessee and Texas lawmakers defined abortion exceptions so narrowly that doctors’ hands remain tied, allowing instances where women’s lives will be at stake. Let us be clear: politicians are practicing medicine without licenses.

Gender-Affirming Care became the site of legislated cruelty. Arkansas expanded malpractice liability. Georgia denied care to incarcerated people. Texas disincentivized insurance coverage.

These policy setbacks are not about health; they are about codified control. They strip dignity, criminalize compassion, and target communities already under siege.

Economic Security revealed both lifelines and leashes. Alabama, Mississippi, and Tennessee expanded paid parental leave, while Arkansas guaranteed free school breakfast. Yet Louisiana tightened unemployment work requirements, making the path to stability tougher for vulnerable families.

Civic Participation was deliberately dismantled. In Mississippi, the Delta—where Black voices are strongest—lost three judicial seats overnight. Representation erased. Justice denied. This is a clear act of deliberate disenfranchisement of Black voters, representing systemic silencing and voter suppression.

Immigration and demographic change exposed the feared South versus the South of promise. The South is becoming more diverse, with immigrant communities reshaping its culture and economy.

Instead of building bridges, legislators passed laws that criminalize caregivers, punish

01

mixed-status families, and vilify immigrants while erasing their contributions. This is violence against community itself. Yet WFS holds hope: bias will not break us, and solidarity will build a South where diversity is our strength.

The Road Ahead is more than a ledger of wins and losses—it is a demand. Policy in the South decides who is protected and who is sacrificed. We uplift not only laws but also the grantees and advocates battling to bend policy toward justice.

Our clarion call is clear: Awareness must become advocacy.

Advocacy must become votes. Votes must deliver leaders who legislate for life, not against it. Survival is not enough. The South we fight for, deserve, and are worthy of is one where women, families, girls, and gender-expansive people of color do not just endure— they thrive, they lead, and refuse to allow their voices, hopes, and dreams to be suffocated into silence.

TOGETHER, WE CAN #SHIFTTHESOUTH. 02

Medicaid Eligibility and Access Related to Maternal & Infant Health WINS Alabama – SB 102: Presumptive Medicaid Eligibility for Pregnant Women

Arkansas – Act 124: Healthy Moms, Healthy Babies Act

Allows qualified health providers to immediately enroll pregnant individuals in Medicaid for up to 60 days while applications are processed, based on proof of pregnancy and income.

Coverage cannot be revoked even if the final application is later denied. This ensures faster access to prenatal care, especially in rural and low-income communities where women of color are disproportionately impacted.

A $45.3M bipartisan package expanding Medicaid access for pregnant people and newborns, presumptive eligibility, remote monitoring, doula and midwifery care, and coverage for licensed birthing centers. Increases affordable care in rural areas and culturally responsive supports for women of color. Does not extend postpartum Medicaid coverage beyond 60 days.

Louisiana – Act 228: Medicaid Coverage for Doula Services

Louisiana – Act 410: Perinatal Behavioral Health Treatment

Starting August 1, 2025, mandates Medicaid coverage for certified doula care, including prenatal, labor, postpartum, breastfeeding, and parenting support. Targets Louisiana’s high maternal and infant mortality rates, especially among Black and Brown women. Research shows that doula support improves birth outcomes and reduces complications.

Requires Medicaid and health benefit plans to cover voluntary inpatient treatment for perinatal psychiatric conditions starting in 2026. Expands mental health access for women during and after pregnancy.

03

Mississippi – HB 662: Presumptive Medicaid Eligibility for Pregnant Women Allows providers to grant temporary Medicaid coverage for prenatal care based on preliminary income data while formal reviews are pending. Removes proof-of-income hurdles for faster access to care. Aims to reduce Mississippiʼs high maternal and infant mortality rates.

Texas – HB 136: Medicaid Lactation Consultation Coverage Requires Medicaid to reimburse certified lactation consultants for breastfeeding support. Helps mothers overcome breastfeeding barriers, particularly Black and Latina women who face lower national breastfeeding rates. Expands access to care for those losing in-person WIC counseling.

Reproductive Healthcare Legislation Related to Maternal Health MIXED

BLOWS

Texas – SB 31 “Life of the Mother Actˮ

Tennessee – SB 1004 (Public Chapter 217)

Clarifies when doctors may perform abortions to save a pregnant patient’s life before an emergency is imminent. Exceptions remain narrow, excluding many medically necessary situations and miscarriage care.

Advocates warn it may still deter doctors from acting promptly, risking preventable deaths.

Defines when abortion is allowed under Tennessee’s criminal ban, listing specific complications but excluding many chronic or serious health risks.

Limits physician discretion in determining medical necessity. Could leave some pregnant women without care until conditions worsen.

Texas – SB 33 Bans governmental entities from using public funds for any abortion assistance, including travel, lodging, childcare, or counseling, even if the abortion occurs outside Texas. Expands liability to local governments, officials, and organizations, enabling lawsuits by citizens or the Attorney General.

Creates a chilling effect on aid for medically necessary abortions.

04

Other Maternal & Infant Health Related Legislation WINS

Tennessee – SB 575 (Public Chapter 99)

Tennessee – SB 849 (Public Chapter 261) Requires state medical, osteopathic, and psychology boards to develop an optional maternal mental health training course. Covers best practices for screening, disorders, treatments, and psychiatric referrals.

Aims to improve provider ability to identify and address maternal mental health needs.

Requires hospitals and birthing centers to provide parents and caregivers with post-birth warning signs before discharge. The Department of Health must also make this information publicly available online. Helps families recognize and act on dangerous postpartum conditions early.

Louisiana – Act 190

Requires insurance coverage for evidence-based home visiting programs for families with newborns and young children.

Services include parenting education, screenings, and community resource referrals. Helps reduce disparities in maternal and infant health outcomes, especially for Black and Indigenous families.

Louisiana – Act 287

Strengthens the Louisiana Doula Registry Board, ensuring representation from all health regions and community-based groups. Allows the board to approve or deny registrations and maintain a statewide reimbursable doula registry. Increases access to culturally responsive doula care that can reduce preterm births and complications.

05

MIXED

TEXAS – HB 713

Exempts providers participating in maternal mortality case reviews from mandatory professional misconduct reporting, allowing access to unredacted records and speeding investigations. Intended to reduce backlog and enable quicker policy responses that could help save lives. Critics warn it could shield malpractice and reduce transparency, which is especially concerning for women of color who face disproportionate risks.

Grantee Highlights Louisiana

In 2025, Birthmark Doulas and Institute of Women and Ethnic Studies advocated for the passing of two major Louisiana laws: HB 454 and HB 514. HB 454 requires Medicaid to cover doula services, including prenatal visits, labor support, and postpartum care, improving access for low-income families and communities of color. HB 514 gives the Louisiana Doula Registry Board full authority to set standards and approve doulas for reimbursement through Medicaid and private insurance.

Arkansas

Arkansas Advocates for Children and Families (AACF) worked to pass HB1004 which would have provided postpartum Medicaid coverage for 12 months to qualifying mothers. Arkansas is the only state that has not extended Medicaid postpartum coverage past 60 days despite consistently having some of the country’s highest maternal and infant mortality rates. AACF helped draft this legislation, worked to craft testimony for the bill’s sponsors and worked with mothers, families, friends, and advocates across the State to testify in support of the bill. Unfortunately, despite passing the House with 71 votes, the bill stalled in the Senate Public Health Committee after failing to get a favorable vote to move the bill to the Senate floor. AACF remains committed and dedicated to resolving this issue and supporting the needs of mothers in Arkansas.

06

II. Gender-Affirming Care BLOWS Arkansas – Act 979 (Amendment to the Protecting Minors from Medical Malpractice Act)

Expands the 2023 law allowing lawsuits against providers of gender-affirming care to minors by explicitly including puberty blockers and hormone therapy and extending the statute of limitations to 15 years after turning 18. Supporters claim it protects former patients, but advocates warn it spreads misinformation, contradicts major medical guidance, and deters doctors from providing care. Creates barriers for transgender youth and contributes to stigma and reduced access to evidence-based services.

Georgia – SB 185

Bans state-funded gender-affirming care, including hormone therapy and surgeries, for incarcerated transgender individuals. Removes access to essential healthcare, increasing mental health risks and vulnerability in prison settings. Advocates argue it is discriminatory and harmful to an already at-risk population.

Texas – SB 1257

Starting September 1, 2025, requires insurers covering gender-affirming care to also cover all related follow-up treatments, including monitoring, mental health services, complication treatment, reversal procedures for life, While framed as comprehensive, advocates warn it could prompt insurers to drop coverage entirely or raise costs, effectively limiting access. Places a unique financial burden on transgender individuals, potentially cutting them off from necessary care.

07

III. Economic Security for Families Family Leave for State Employees WINS Alabama – SB 199

Provides eight weeks of paid parental leave for eligible female state and public education employees after birth, stillbirth, or miscarriage, two weeks for male employees, and eight weeks for either parent adopting a child age three or younger.

Mandates rulemaking and annual reporting.

Reduces financial stress, promotes recovery and bonding, and advances gender equity in the workplace.

Mississippi – HB 1063

Establishes eight weeks of fully paid leave for a primary caregiver and two weeks for a secondary caregiver following birth or adoption for state employees, plus up to six additional weeks of major medical leave. Applies to state government employees, with optional adoption by school districts and community colleges. Improves economic stability and recovery time during the postpartum period, setting a precedent for broader paid leave expansion.

Tennessee – SB 322

Grants eligible state employees up to six weeks paid leave to care for family members with serious health conditions, including grandparents, siblings, and close associates.

Leave can be taken intermittently or on a reduced schedule. First Southern state to extend paid family leave beyond childcare, supporting caregiving for seriously ill loved ones.

08

Other Legislation Related to Economic Security WINS

Alabama – HB 152

Arkansas – Act 123

Removes state sales tax on baby formula, diapers, wipes, breast pumps, maternity clothes, and menstrual products. Provides direct economic relief, especially to low-income households and women and girls of color. Reduces structural costs tied to caregiving and reproductive health.

Guarantees one free breakfast daily for every public school student. Addresses food insecurity among low-income children, supporting better health and academic success.

BLOWS

Louisiana – Act 151 Increases weekly unemployment benefit work search requirements from three to five.

Disproportionately impacts rural residents, caregivers, and those with limited transportation or internet access. Risk of disqualification exacerbates financial instability for vulnerable families.

09

IV. Civic Participation BLOW Mississippi – SB 2768

Redraws judicial districts, eliminating three seats in the Mississippi Delta, a region with a large Black population. Reduces access to local judges familiar with community needs, potentially harming trust and timely access to justice. Creates greater barriers for marginalized women in pursuing domestic violence, custody, or criminal cases.

Grantee Highlights Mississippi – One Voice strongly opposed efforts to eliminate the state income tax, writing op-eds and publishing analysis to demonstrate how the policy would deliver a windfall for the wealthy while jeopardizing critical public services that support Mississippians. The legislation also included a gradual reduction in grocery taxes, which offers limited relief but is outweighed by increased costs elsewhere. Although the measure passed, One Voice continues to hold legislators accountable by forecasting the law’s long-term harm to communities. One Voice also celebrated a victory for paid family leave and successfully fought off another attempt to expand private school vouchers.

Georgia – Women on the Rise was key to passing Georgia’s Survivor Justice Act (HB 582) in 2025. The law protects survivors of abuse from being punished for actions taken in self-defense or under coercion. It allows evidence of past abuse in court and gives incarcerated survivors a chance to seek resentencing. Women on the Rise brought this issue to the forefront, securing bipartisan support and advancing a trauma-informed, survivor-centered justice system in Georgia.

10

Immigration Legislation in the South In 2025, a wave of immigration-related laws swept through Southern states, escalating threats to the health, wealth, and power of women and girls of color—particularly those from immigrant and mixed-status families. These measures criminalize caregiving, expand surveillance, and deepen distrust in public institutions, eroding the safety nets entire communities depend on.

ALABAMA criminalized transporting someone without lawful status across state lines, even for basic caregiving like driving a family member to a doctor’s appointment—placing compassion itself under threat.

TEXAS expanded local–federal law enforcement collaboration (SB 8), embedding immigration enforcement into community policing, and advanced SB 825, a cost-only study of undocumented immigration that ignores economic contributions, fueling harmful narratives.

LOUISIANA mandated that noncitizens requesting public assistance be reported to ICE (Act 351), deterring eligible families from seeking essential food or healthcare aid for their children out of fear of detention or deportation.

TENNESSEE passed some of the most aggressive laws, including the creation of a centralized immigration enforcement unit, new ID restrictions, civil liability for charities housing undocumented people, and criminal penalties for harboring them.

Collectively, these laws normalize the idea that survival, solidarity, and care can be crimes when immigrants are involved. They choke access to healthcare, education, and economic stability, while sowing fear and mistrust that fractures communities. In doing so, they do not just target immigrants—they destabilize the very systems that sustain public health, safety, and equity in the American South.

11

We would like to thank the Kresge Foundation, Mary Reynolds Babcock Foundation, Pivotal Ventures, Robert Wood Johnson Foundation, and W.K. Kellogg Foundation for supporting the work of the Women’s Foundation of the South.

SOURCES Information regarding the laws was obtained from the following sources: 1.

Alabama Legislature. (n.d.). Legislative information system. Retrieved June 2025 from https://www.legislature.state.al.us/ .

2.

Arkansas State Legislature. (2025). Retrieved June 2025 from https://www.arkleg.state.ar.us/ .

3.

Georgia General Assembly. (n.d.). Official website of the Georgia General Assembly.

Retrieved June 2025 from https://www.legis.ga.gov/ .

4.

Louisiana State Legislature. (n.d.). Louisiana laws and legislation. Retrieved June 2025 from https://www.legis.la.gov/ .

5.

Mississippi Legislature. (n.d.). Official website of the Mississippi Legislature. Retrieved June 2025 from https://www.legislature.ms.gov/ .

6.

Tennessee General Assembly. (n.d.). Tennessee General Assembly website. Retrieved June 2025 from https://wapp.capitol.tn.gov/ .

7.

Texas Legislature Online. (n.d.). Legislative information for the Texas Legislature. Retrieved June 2025 from https://capitol.texas.gov/ .

CONTACT US To learn more about or support the Women’s Foundation of the South, please visit www.womensfoundationsouth.org. You can also find us on Facebook @womensfdnsouth and Instagram @womensfdnsouth. To contact us, please write info@womensfoundationsouth.org.

12

#SHIFTTHESOUTH