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Insurance Hassles Complicate Access to Breastfeeding Benefits Under ACA

Insurance Hassles Complicate Access to Breastfeeding Benefits Under ACA

October 2, 2013 — Despite an Affordable Care Act (PL 111-148) provision that requires health plans to cover breast pumps and lactation counseling for new mothers, many women have found it difficult to access breastfeeding support while insurers are updating their policies, New York Times' "Well" reports.

According to "Well," many mothers report it has been "nearly impossible to get timely help" since Jan. 1, when insurers began revising their policies. Some insurers direct women to pediatricians, who are not necessarily trained in lactation support. Often, women facing problems such as insufficient milk supply or infections must locate services on their own, which can lead to delays that could further jeopardize their milk supply.

Susanne Madden, founder of the National Breastfeeding Center, said, "It's abysmal, the state of lactation services being provided by insurance companies." In August, NBfC published an assessment of insurers' breastfeeding policies across the country. Twenty-eight of 79 plans received grades of D or F.

HHS has told insurers they must cover out-of-network lactation consultants if they do not have a trained provider in their normal network.

HHS spokesperson Joanne Peters said, "We are committed to working with insurers and consumers to ensure that women receive the benefits they are entitled to under the law" (Saint Louis, "Well," New York Times, 9/30).