By Lisa Stiffler, Seattle Times
This story was produced in partnership with
So it’s a little surprising that many moms aren’t up to speed on how the Affordable Care Act could benefit them. The law has specific requirements targeting moms, including coverage for breast pumps and consultants to help breast-feeding mothers.
“So many moms don’t know about the benefit,” said Cary Seely, director of provider relations at Pumping Essentials, a California-based company selling supplies and services to assist in breast-feeding.
While many of the changes mandated by the Affordable Care Act will benefit low-income Americans by expanding access to health insurance, the Obama administration has tried to build support among a wide swath of the public. Officials routinely tout reforms included in the new law that are designed to help the middle class. Among them are provisions that mandate insurance coverage regardless of pre-existing conditions; allow adult kids to stay on their parents’ insurance plans until they’re 26; require free preventive services such as mammograms, colonoscopies and flu shots - and institute the breast-feeding provisions.
But in a recent poll, only 36 percent of Americans surveyed said the law “will make things better” for the middle class.
When Whitney Courson, of Seattle, was pregnant earlier this year with her first son, a friend advised her that her insurance might pay for a breast pump, which generally costs $200 to $400 for an electric model. She forgot about the tip, even putting the pump on her baby-gift registry, hoping someone would buy it for her. Then another parent mentioned the benefit at a childbirth class.
This time, Courson called a representative at Premera Blue Cross, her insurance provider through her husband’s job at Amazon.com, and learned it would cover the cost of a breast pump. She bought one and had her baby, Nicholas, in July.
She loves the ability to pump and store milk so that she can bottle-feed her son when she needs to, or so that someone else can feed him in her absence.
“Now I’m telling everybody I know, ‘Call your insurance, this is amazing,’ ” she said.
The Affordable Care Act provision supporting breast-feeding went into effect for new health-insurance plans a year ago, but many plans didn’t incorporate the benefit until January 2013, when they were renewed.
One hurdle to more widespread use of the provision is the vague language used to describe it, leaving insurance companies to come up with their own interpretations of what it means.
Many plans require women to purchase their supplies from an approved medical-device provider, while other others will allow a mom to get reimbursed for a purchase made anywhere. Some will pay only for a handheld, nonelectric device, while others cover more premium pumps. The rule is even more unclear on the lactation-support provision, with no definition of who is qualified to assist a woman trying to breast-feed.
When Courson initially found breast-feeding difficult, she again turned to her insurance provider.
“I had so many questions and concerns. I wanted to see a lactation consultant so I called insurance just to see.”
Courson learned that she had coverage for counseling, and found a provider who would visit her home. Now more than a month after delivering Nicholas, breast-feeding is going well.
“Knowing this kind of care is available and covered ... that is huge,” she said.
Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communications organization not affiliated with Kaiser Permanente.