A big change in public policy could bring mothers and their new babies much closer from now on. As of January 1, a provision of the Affordable Care Act, the health reform legislation passed by Congress in 2010, now requires that health insurers cover the cost of  breast pumps and lactation services for new moms. Before now, no state law required insurers to cover breast pumps.  Thirty-one states made them available through the Medicaid system to low income women only. The new law compels  insurers to provide lactation benefits without insisting on a co-payment from the insured mother. The premiums charged to all insureds will be paying for the pumps, as part of the basic coverages offered.

This is a big deal.  Maternity care was often excluded under health insurance on the private individual market. About a dozen states required it. Insurers in other states  didn’t offer it at all, or offered it as an additional purchase with a separate rider and/or imposed a waiting period of  six months or several years. Millions of women would discover, to their dismay, that their prenatal, delivery, and post-natal care would be paid for out of their own pockets. Considering that about half of U.S. pregnancies are unplanned, and that the costs for pregnancy and delivery care can easily reach $15,000,  the impact is significant.

There was a lot of controversy over the extent of health insurance coverage that the new law would require. In a memorable display of male self-absorption, Senator John Kyl from Arizona stated during congressional testimony that since he, as a  man, would never need maternity care, it should not be part of the standard coverage available under the reform law. (The fact that all babies, whether male or female, do not suddenly appear, unaided, in the arms of their mothers with a joyful “Ta DA!” evidently eluded him.) Lurking behind all the objections to uniquely feminine health needs, such as maternity care, mammograms, contraception, and so forth, seems to be the notion that “standard” is the care a man needs, and anything else is exceptional, optional or somehow elective. Due to advocacy from women’s groups, such as the National Women’s Law Center and others, medical care for women was not entirely absent from the final draft of the reform bill which became law. The provisions of the bill requiring coverage for pregnancy and maternity care will go into effect in 2014.

Coverage for breast pumps, however, is effective right now. So, too is a provision that gives breastfeeding employees who are “hourly workers” a right to reasonable break time and a private, non-bathroom location to express breast milk up to the child’s first birthday. The policy changes have caused an  uptick in demand for breast pumps, a real hot commodity in medical equipment supplies. As reported by The Washington Post:

Yummy Mummy, a New York boutique that specializes in breast pumps and accessories, is in the process of acquiring a warehouse and call center to accommodate the increased demand. “I have three employees taking calls right now,” owner Amanda Cole said. “We’re still in the stage where we’re figuring out how to add fax machines and phone lines. It’s all very new to us.”

This is a terrific example of what changes when women are involved in policy making. It’s no coincidence that this kind of legislation was enacted when more women were in Congress and a woman occupied the Speaker’s chair in the House. As the new congressional session, our 113th so far, gets underway, the female members of the House and Senate will have a whole lot to do. Promoting “women’s issues” as human issues will be a big part of that. It surely won’t be easy. I’m behind them 110 percent.

‘Til next time,

Your (Wo)Man in Washington