By Marsha Walker, RN, IBCLC, USLCA Director of Public Policy

Many mothers need breastfeeding help, but cannot access the level of care that they need.

Even though the Affordable Care Act requires breastfeeding support, it does not specify the provider that best fulfills this mandate. Many insurers will not credential IBCLCs nor maintain IBCLC networks because IBCLCs are not licensed. Breastfeeding care becomes more fragmented and deferred to providers who may not have the training or expertise to handle complex lactation situations. This means that many breastfeeding women are without the care they need, when they need it the most.

Your voice is needed.

The Department of Health and Human Services (HHS) is creating rules for insurance companies in the individual and small group markets under the new health care law. As part of this effort, they will take comments from the public about what services insurance companies must cover. Use this opportunity to tell HHS that mothers should have access to IBCLCs, that insurers should cover the services of the IBCLC, and that all breastfeeding mothers deserve access to IBCLCs, not just those who can afford it.

We’ve made a lot of progress – but there’s still more to be done. Send in your comments at HERE. Comments are due by 5:00 PM Eastern time on December 26, 2012. The entire proposed rule can be found HERE.

The US Lactation Consultant Association is working hard to assure that IBCLC services are available to all women. Thank you for all you do to ensure women have access to quality, affordable health care. Your letter needs to be brief as the portal allows only 2000 characters. You can cut and paste the following sample letter into the comment portal HERE.

Please state that insurance companies must cover the services of the International Board Certified Lactation Consultant (IBCLC) in the maternal and newborn section of the Essential Health Benefits (EHB). IBCLCs are allied health professionals certified through a rigorous credentialing process who possess the requisite skills to manage common and complex lactation management issues. Too many breastfeeding mothers lack access to the level of care that they need, resulting in fragmented care deferred to providers who may not have the training or expertise to handle complex lactation situations. See http://massbreastfeeding.org/landscape/ for a guide to lactation qualifications. This drives up the cost of and increases the number of health claims due to increased infant illnesses and conditions preventable by successful breastfeeding. Services of IBCLCs result lower health care costs to insurers. The U.S. Surgeon General included in the 2011 Call to Action to Support Breastfeeding, the specific recommendation to provide reimbursement for IBCLCs independent of their having other professional certification or licensure. The Centers for Disease Control and Prevention use the IBCLC as a metric in its determination of the adequacy of breastfeeding support in its annual Breastfeeding Report Card. 

State required benefits should include IBCLC services to improve the quality and value of the coverage that is available for EHB. Please include coverage of IBCLC services under Sec. 147.150 Coverage of essential health benefits. Beginning in 2014, all non grandfathered health insurance coverage in the individual and small group markets, Medicaid benchmark and benchmark-equivalent plans, and Basic Health Programs (if applicable) will be required to cover essential health benefits. I strongly encourage Secretary Sebelius to expressly declare in the text of the final rule that health plans specifically state that coverage will be available for IBCLC services.

Thank you for helping USLCA with their advocacy efforts to bring increased access to lactation care for mothers, babies, and their families.