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The Affordable Care Act and Breastfeeding

Support for breastfeeding doesn’t just come from our healthcare providers, partners, friends, and family. It also comes from federal policies and regulations that aim to make breastfeeding support more accessible and more affordable.

If you’re thinking about breastfeeding your baby, you’re likely aware of all the benefits that it offers, including:

But what do you know about the laws and regulations that are in place to support breastfeeding parents?

This can be a grey area for a lot of new parents. Between varying state laws, inconsistent insurance policy benefits, and a wide range of social attitudes, it’s hard to know exactly what rights and protection a breastfeeding parent gets.

Let’s break that down for you so you can move forward and breastfeed with confidence!

How the Affordable Care Act changed breastfeeding

Insurance benefits for pregnancy, childbirth, and maternal health can be tricky to understand in the first place. No wonder! Each provider and each plan are different in how they address everything that goes into it.

Before the ACA, breastfeeding support through insurance was anyone’s game—there were no mandates to cover anything comprehensively having to do with breastfeeding. Some insurance policies may have been generous with access to high-quality breast pumps, lactation consultant visits, and even shipping milk. Still, lots of parents had zero support, even when they were covered by insurance.

The Affordable Care Act (ACA), signed into law by President Barack Obama in March 2010, changed this in two meaningful ways :

  • Mandated that mothers needed to be given reasonable break time and private space to express milk for up to 1 year after giving birth.
  • Required health insurance benefits to lower costs associated with providing breast milk to children.

How the ACA changed breastfeeding insurance coverage

Under the ACA, all private insurance companies have to provide coverage for comprehensive breastfeeding support — without any out-of-pocket costs for parents.

Getting the breastfeeding support you deserve through ACA

Since the ACA went into effect in 2010, insurance companies have changed their breastfeeding coverage policies. You should check with your insurance provider to see:

  • What kind of pump—brand, type of pump, and features—you’re entitled to have?
  • When and where can you get the pump?
  • Whether renting a hospital-grade pump is covered?
  • How much lactation support can you access?
  • Do you need preauthorization to work with a lactation consultant?
  • Where can you find a list of in-network lactation consultants?

If your provider doesn’t provide the kind of coverage, services, or support you need, you have options.

At this time, approximately 60% of healthcare plans let parents upgrade from a basic breast pump to a higher grade as long as the parent pays the difference. Typically, plans require that you choose your breast pump from a provider in your network, but if the pump you want isn’t available, most will let you choose from another store or reimburse purchases from a retail outlet.

Not sure where to start? We get it — wading through insurance policies isn’t fun. If your plan doesn’t provide detailed information about how you can access lactation support, there are a couple of ways you can get clarity:

That translates to this: Every time you give birth, your insurance provider has to offer you a breast pump AND access to breastfeeding education and support (i.e., lactation counseling) without making you take on a copay.

The ACA mandate doesn’t mean there aren’t variations in plans, though. The way your health insurance handles breastfeeding support will differ, but experienced IBCLCs can help you navigate the complexities of in-network and out-of-network coverage.

  • Ask your insurance for a list of certified providers in your network. (Note: This shouldn’t be a list of OB-GYNs, pediatricians, or hospitals.)
  • Ask about coverage for out-of-network providers. This is particularly helpful if your plan doesn’t offer many in-network options
  • Ask a Nest Collaborative IBCLC!

Ask questions and ask for help

Insurance is complicated. We can help. Nest Collaborative is 100% covered by most insurance providers. We’re here to answer your questions and help you find solutions. Book a convenient online video appointment with a Nest Collaborative IBCLC today.

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