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Health Care Reform:

Health Insurance & Affordable Care Act

Expert Spotlight: Breastfeeding

With the Affordable Care Act, nursing your baby is becoming easier and more affordable. Cathy Carothers, co-director of Every Mother, Inc. and past chair of the United States Breastfeeding Committee, talks about health care reform and the breastfeeding support it offers. 

What does the Affordable Care Act cover?

The ACA provides breastfeeding support in two main ways. The first is in the workplace. Mothers who are eligible for overtime pay now have the right to both time and a private place that is not a bathroom to express, or pump, their milk at work. Many moms are going back to work, but it's not always a place that is friendly to breastfeeding. The law now requires many businesses to provide accommodations on-site. The law also requires most insurance plans to help with the cost of breastfeeding support and equipment.

What is covered as "breastfeeding support”?

Most health plans are required to provide breastfeeding support for new mothers. These rules, however, do not apply to grandfathered plans, or those that were already in place when the law took effect and have not made certain changes in the meantime. Mothers should always check with their insurance plan to see what is covered. The intent of the law is breastfeeding support and counseling both before and after the baby is born. That may include one-on-one visits with a lactation consultant or other expert in the plan’s network of providers.

These visits could be for a baby who isn’t latching on very well, a mom who isn’t making enough milk, a mom who is having a tough time getting baby to latch on in a way that is comfortable, or a baby who isn’t gaining weight.

Not all mothers need breastfeeding support. The good news is that breastfeeding is not usually about problems. Often when women are prepared and know what to expect and get some information during their pregnancy, it can be wonderful and go without a hitch.

What is covered as "breastfeeding equipment”?

In this area, a lot of mothers often are on their own. They might go to a local retail store and try to pick out a pump they think is going to work, and it may not be what's going to work in their particular situation. The ACA now requires that most health insurance plans cover the cost of breastfeeding equipment, including pumps. This might be either renting a quality breast pump or purchasing one that is right for the mom’s situation. For example, a mom who is not with her hospitalized baby will need a high-quality rental-grade pump to keep up her milk supply. A mom going to work might need a personal double electric pump to cut down on the amount of time she needs to pump during her breaks. A mom who needs to express milk only every now and then might do fine with a manual pump. Moms should talk to their doctor or a lactation expert about the kind of pump that’s right for them and work with [their] insurance company on what is covered.

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