By Kate Greenwood
Cross-Posted at Health Reform Watch
For most women who work outside the home—Gisele Bundchen excepted—breastfeeding on the job is not an option. Pumping breast milk during the work day is more likely to be a realistic, if often challenging, choice.
As I blogged about here, Section 4207 of the Patient Protection and Affordable Care Act amended the Fair Labor Standards Act to require that employers provide their non-exempt employees with reasonable unpaid breaks to express breast milk, and “a place, other than a bathroom, that is shielded from view and free from intrusion from coworkers and the public” in which to do it. Employers with less than 50 employees are relieved of the requirement to the extent that it “would impose an undue hardship by causing the employer significant difficulty or expense when considered in relation to the size, financial resources, nature, or structure of the employer’s business.” In addition, under the Health Resources and Services Administration guidelines implementing PPACA’s women’s preventive services mandate, insurance plans must cover “costs for renting breastfeeding equipment” such as breast pumps and related supplies.
According to news reports (e.g., here, here, and here), new mothers have had some difficulty turning PPACA’s promise of a breast pump into a reality. Many insurers require that women go through a durable medical equipment provider, but many durable medical equipment providers do not stock breast pumps. In addition, insurers vary in what type of pump they cover. Writing in the Winston-Salem Journal late last month, neonatal nurse practitioner Tinisha Lambeth reports that:
“Some mothers of premature infants qualify for a manual breast pump, while some mothers of full-term babies qualify for (unnecessary) hospital-grade electric pumps. Still others will get a dual electric pump, which are not as effective as a hospital-grade electric pump for an extended period of time, but are adequate for supplying full-term babies. It all depends on your coverage.”