Author: Kennedi Munson

Public Support for Same-Sex Marriage Falls From Recent Highs

Posted on by Kennedi Munson

On June 26th, 2015, in a 5-4 ruling, the Supreme Court issued Obergefell v. Hodges, a landmark decision that legalized same-sex marriage in the United States. For over a decade, the ruling has remained in effect under the Fourteenth Amendment, Equal Protection Clause, and Due Process Clauses. 

When Obergefell was decided, 60% of U.S. adults believed “same-sex marriages should be valid,” and 63% said that “gay or lesbian relations are morally acceptable.” Support has steadily increased amongst U.S. adults since 1996, reaching an all-time peak in 2022. At that point, 71% of U.S adults supported same-sex marriage, and 71% viewed same-sex relationships as morally acceptable. 

Many believe the Supreme Court’s decision to overturn Roe v. Wade contributed to the surge in support. The ruling raised concerns that other rights-based decisions, including Obergefell, could face future challenges. If Roe v Wade could be threatened and overturned by the Supreme Court, then who was next? 

Those fears helped mobilize support for LGBTQIA+rights and contribute to the passage of The Respect for Marriage Act in 2022. This bill requires federal, state, and territorial governments to recognize the validity of same-sex and interracial marriages. 

However, recent polling suggests public support may be slipping. Support for same-sex marriage declined from 71% in 2023 to 69% in 2024. By May 2026, that number had fallen to 65%.     

The decline has coincided with increasing political polarization. Since returning to office in 2025, President Trump has signed several executive orders affecting LGBTQIA+ Americans. These include Executive Order 14168 which federally recognizes two sexes, male and female; Executive Order 14187, banning gender-affirming care for individuals under 19; and Executive Order 14151 which ended many Diversity, Equity, and Inclusion (DEI) programs.  

Support for same-sex marriage has fallen most sharply among Republicans, dropping from 55% in 2022 to 37% today. Nevertheless, this decline extends beyond one political party. Democratic support has decreased from 85% to 81%, while support among Independents has fallen from 72% to 64%. 

These trends highlight a larger national issue at hand: the collective rampant intolerance towards marginalized communities. A singular political party or administration is not to blame for the general issue Americans have with supporting the LGBTQIA+ community. 

At the same time, polling data does not always reflect the lived experiences of LGBTQ+ people. In 2022, the same year support for same-sex marriage peaked, it marked one of the deadliest years for transgender people. More specifically, 84% of victims of violence against transgender and gender non-conforming people were people of color. A paradox between poll statistics and the lived experiences of the LGBTQIA+ community is a reminder that structural and systemic amendments also need to be made for holistic support. 

With June signifying Pride month, the decline in support for the LGBTQIA+ community, coupled with the cases of fatal violence that community members face, highlights why this month is so necessary to spotlight. This Pride, and throughout the year, it is important that everyone makes a concerted effort to lean into love, community, and mutual aid, as those are the essential tools that will uplift us through these times.  

More Than Half of States Now Cover Doula Care Under Medicaid

Posted on by Kennedi Munson

As of April 2026, over half of U.S. states, along with Washington, D.C., provide Medicaid coverage for doula care. 27 states and D.C. currently offer coverage, while seven additional states (Arkansas, Maine, Montana, Nebraska, New Hampshire, Tennessee, and Vermont) are in the process of implementing programs. 

Under these policies, Medicaid enrollees can receive coverage for doula services, while certified doulas are reimbursed for prenatal and postpartum visits, as well as labor and delivery attendance. 

The expansion comes as the United States continues to face a maternal health crisis. The U.S. has the highest maternal mortality rate among comparable high-income countries, with 18.4 maternal deaths per 100,000 live births. The rate is significantly higher for Black women, who experience 50.3 maternal deaths per 100,000 live births. 

In response to these disparities, many Black and Indigenous communities have long relied on doula care as a source of support throughout pregnancy, childbirth, and the postpartum period. However, doula services have historically not been covered by Medicaid or private insurance, limiting access for many low-income families.

Doulas are trained, non-clinical professionals who provide physical, emotional, and educational support during pregnancy, birth, and postpartum recovery. The expansion of state doula coverage through Medicaid marks a valuable enhancement of the perinatal health workforce that promotes evidence-based education, connections to resources, and support during delivery. 

Oregon became the first state to explore Medicaid coverage for doulas, when it enacted H.B. 3311 inJune 2011. Minnesota followed in 2013, with the passage of  SF 699.  Since then, momentum has steadily grown across the country.

Implementation varies by state. In Virginia, for example, doulas must first become certified through the Virginia Certification Board, register as network providers, enroll in Medicaid, and complete 60 hours of training before providing services. 

Despite growing support for Medicaid-funded doula care, challenges remain. Some doulas have called for “more awareness and outreach, and continuing to give evidence-based information on how doulas are actually beneficial throughout the pregnancy, birth, and postpartum periods.”

Awareness remains a significant barrier. In 2013, only 6% of women reported using doula services. While utilization has increased since then, many pregnant patients are still unaware that they may be eligible for Medicaid-covered doula care. Other challenges doulas have expressed with Medicaid coverage for their care include: a shortage of doulas in some regions, limited Medicaid reimbursements, and independent doulas wanting to be more involved in discussions with state Medicaid staff. 

As more states expand Medicaid coverage for doula care, addressing these challenges will be critical to ensuring that patients can fully benefit from these services. Greater awareness, stronger support for the doula workforce, and more equitable implementation could help reduce maternal mortality rates and improve reproductive health outcomes, particularly for historically marginalized communities.

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