This weekend, the Washington Post published an article describing how the breast pump industry is faring now that the health care law requires health insurance coverage of such pumps. The article quoted our very own Judy Waxman and yours truly. As expected, there were many comments from readers vehemently disagreeing with the premise of covering breast pumps. The gist of the complaint is: “why should I pay for other peoples’ breast pumps. Why do women get these things for free?”

My initial response to these complaints is – as I have explained time and again – women are not getting their birth control or pumps for “free.” They are paying for it when they pay for health insurance, either by working for it and having it included as part of the employee’s benefit package (and likely still paying part of the premium) or by paying for it directly on the individual market. So this stuff isn’t “free,” the woman IS paying for it. Do you call the preventive care visits that now don’t have a no co-pay as “free?” No, it is not free. You pay premiums to your health insurance company so that they cover these medical care costs when you need such care.

Look, I get it. Ideas such as covering birth control or breast pumps are real cutting edge stuff. For many reasons – including some deeply-entrenched sexist ones – people don’t think of these things as medical care. The problem is that these medical needs are mainly “women’s” and, unfortunately, women have long faced discrimination in the world of health care coverage. In the Law Center’s most recent report on insurance discrimination against women, we reported that the vast majority of individual market plans do not cover maternity care and that women often pay significantly more for health care coverage. So while some may be arguing that they just don’t agree with the coverage of breast pumps or birth control, I think that this is all related to our country’s long history with excluding coverage of women’s health care needs.

Fortunately, this is all changing with the passage of the health care law (where things like gender rating are outlawed and maternity care is required coverage). But just because the law is changing insurance practice doesn’t mean societal attitudes have yet changed.

The reality is that society still has a long way to go in recognizing all of women’s medical needs. Just look at how Sandra Fluke was treated during the birth control debate. Birth control and breast pumps are health care, believe me, I would not be using them otherwise. Anyone who has used a breast pump knows, it is NOT some fun activity that I am doing just for kicks. They aren’t some fashionable accessory I want my health insurance to cover. No, only due to the deep love of my child do I suffer through the pumping, cleaning, and storing process that I repeat several times a day. All to make sure my kid gets the best nourishment available to encourage his long term health and hopefully reduce our overall healthcare spending.  

Now that seems reasonable enough to me… am I missing something?