Stories about organizations fighting the clause in the new Affordable Care Act or referred to as Obamacare which requires companies to cover birth control have dominated the headlines as of late, but a lesser known clause is causing a scramble to provide new mothers with breast pumps.
Small clause creates big stir
Some of the ACA clauses and conditions kicked in January 1, 2013. One of these is a requirement that breast pumps are covered by insurance companies. New mothers can get free consultations with lactation experts at no cost to them as well. Many medical suppliers that accept insurance have begun to stock up on pumps to meet the demand.
It is now up to insurers to figure out how to comply with the new regulations. The cost must be absorbed by the insurance companies, which could result in a small bump in premiums for the insured. Breast pumps have never been entirely covered under private health insurance, though some have done so for reasons deemed medically necessary. At the present time, Medicaid recipients in 31 states already have access to breast pumps.
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Fulfilling the obligation
There is some ambiguity as to what has to be covered and how it should be done. The law does not specify types of pumps that must be covered. The plan states a policy must cover the cost of renting breastfeeding equipment for each baby born. Rentals are commonly hospital-grade pumps that are more expensive, larger, and harder to clean. Commercial grade pumps are not designed for long-term use but are less expensive and more portable. No specifications were made for types or brands of pumps.
Each insurance company has been left to decide what they want to cover to comply with the ACA clause. Some will cover rentals and will also cover commercial brands. Some will simply pay for rentals. Lactation consultants are being recruited to be part of insurance networks, but some are refusing, stating low returns. The required payment is less than half of what some consultants command per hour in private practice.
Demand exceeds supply
Suppliers of breast pump rentals and for-sale units must be a part of the insurance network, which leaves some new moms with no where to turn. Many are told they must go with a medical supplier on the plan, only to find that all of the suppliers are out of pumps. Until more suppliers are signed up as vendors to fill the demand created by the new healthcare law, some new families are coming up empty handed when seeking pumps.