An Overview of the Changes to Maternity Care and Breastfeeding Under the Affordable Care Act

In 2010, President Obama signed the Affordable Care Act into law. The goal of this legislation is to make health care more affordable, accessible and better. But the legislation is long and complicated.

Few of us—certainly not the ever multi-tasking women, anxiously expectant mothers, or the expertly juggling mamas among us—have time to sift through the details and understand the how the changes within the Affordable Care Act actually impact your life and your dollars.

Here’s an overview of the act with respect to improvements in maternity care, specifically breastfeeding (taken, in some cases, directly from http://www.hhs.gov/healthcare/facts/factsheets/2015/05/affordable-care-act-maternity-care.html).     

The Affordable Care Act provides unique coverage allowances to women, acknowledging that the health and medical needs of American women are disproportionately costly. For example, the average cost for prenatal care and delivery in an uncomplicated birth is $20,000. (1) Additionally, the law addresses disparities in access to quality and affordable health coverage while specifically promoting efforts focused on wellness and prevention. (According to the Centers for Disease Control and Prevention, breastfeeding is one of the most effective preventative measures a mother can provide for herself and her child, this the new attention and allowances. (2))

Unique Coverage & Improved Benefits for Women under the Affordable Care Act:

• 10 essential health benefit categories, including maternity and newborn care.

• 22 preventative services for maternity care and childbirth, before and after a child’s birth. 

• Additional preventive services with no cost-sharing, such as well-woman visits, screening for gestational diabetes, domestic violence screening, breastfeeding supplies and contraceptive services. (3)

Specific services and provisions for breastfeeding include:

•  A breast pump is fully covered under most health insurance plans.

• Breastfeeding support and counseling is covered under most health insurance plans.

Coverage of breast pumps:

• Your health insurance plan must cover the cost of a breast pump – and may offer to cover either a rental or a new one for you to keep

• Your plan may have guidelines on whether the covered pump is manual or electric, how long the coverage of a rented pump lasts, and when they’ll provide the pump (before or after birth).

• But it’s up to you and your doctor to decide what's right for you.

• In many cases, your insurance plan will follow your doctor’s recommendations on what is medically appropriate. Some insurance plans may require pre-authorization from your doctor to ensure the proper services are provided. Talk to your doctor to find out what this means for you.

• Contact your insurance plan for questions about your breastfeeding benefits.

Break Time for Nursing Mothers:
The Affordable Care Act amended the Fair Labor Standards Act (FLSA), which covers most hourly wage–earning and some salaried employees. Many employers are required to help their employees who are nursing moms in two ways:

• Workers must be given “reasonable” break time to pump for a breastfeeding child, as frequently as needed by the nursing mother, for up to 1 year after the child’s birth. 

• Women who need to pump or nurse must be given a private space. This space cannot be a bathroom.

Hopefully, this overview (and bullet points taken directly from http://www.hhs.gov/healthcare/facts/factsheets/2015/05/affordable-care-act-maternity-care.html) helps to explain how the Affordable Care Act can actually impact your life and your dollars.

For further reading, please visit:
https://www.healthcare.gov/coverage/breast-feeding-benefits/

http://www.dol.gov/whd/nursingmothers/

http://www.hhs.gov/healthcare/facts/timeline/index.html

http://www.cdc.gov/breastfeeding/pdf/BF-Guide-508.PDF

For much of the information found in this post, we thank:

http://www.hhs.gov/healthcare/facts/factsheets/2015/05/affordable-care-act-maternity-care.html

Citations:

[1] ASPE Computation using 2011 Medical Expenditure Panel Survey (MEPS)

[2] Strategies to Prevent Obesity and Other Chronic Diseases: The CDC Guide to Strategies to Support Breastfeeding Mothers and Babies. See also: Ip S, Chung M, Raman G, et al. Breastfeeding and maternal and infant health outcomes in developed countries. Evid Rep Technol Assess. 2007(153):1-186.
[3] http://aspe.hhs.gov/health/reports/2014/PreventiveServices/ib_PreventiveServices.pdf

Our resident "Moms Who Know" informed this post and our writers composed it. No one contributing to this post is a trained medical professional. For further reading and information on familiarizing yourself with your breast pump, please visit the websites for any of the five brands Byram Healthcare proudly distributes:

http://medelabreastfeedingus.com
http://ameda.com/breast-pumping/getting-started
http://freemie.com/index.html
http://hygeiainc.com
http://www.spectrababyusa.com