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 their 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 were 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 their hospitalized baby will need a high-quality rental-grade pump to keep up their milk supply. A mom going to work might need a personal double electric pump to cut down on the amount of time they need to pump during their 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, because insurers are not required to cover all types of pumps.
Are there any costs for breastfeeding help?
The ACA breastfeeding benefits are to be covered without a copay, coinsurance, or a deductible. That works great if Mom has an insurance company that is required to comply with the law. Some policies are grandfathered in and thus exempt. Check first to see if yours has to meet this requirement of the ACA.
Can you get breastfeeding help before you have your baby?
It can come before and after the mom has their baby. That means the mom can see a lactation consultant and get some education during their pregnancy. Moms who are prepared often have a much easier time. Certainly the support can come after the baby is born, too. It can include going to classes or support group meetings and consultations.
What if you already had breastfeeding help with another baby? Can you get it again?
The good news is help does apply to every baby a mom has. That’s because every baby is completely different and has unique needs. Mothers know this. Moms grow in their experience, but even experienced moms may need support with each baby because it’s still the first time to breastfeed that baby. There can always be different situations and different challenges that come up.
Where else can you get help?
The International Lactation Consultant Association has a directory of lactation consultants by ZIP code. For general questions, call your local Women, Infants, and Children (WIC) program, the breastfeeding coalition in your state, or La Leche League. You can also call the hospital where you delivered. Most have someone trained in breastfeeding on staff. Calling them might be a good first step for a mom. Check with a nurse or lactation consultant at the hospital if you’re concerned about how breastfeeding is going, and they can let you know who can help.
* Short-term health plans, those that provide less than 12 months of coverage, do not have to provide breastfeeding support or equipment.