National Women’s Law Center report names insurance companies, calls for better enforcement of the law
A report released today by the National Women’s Law Center (NWLC) exposes at least 20 insurance companies that are violating the Affordable Care Act’s (ACA) breastfeeding benefits and identified troubling trends in insurance company compliance that are likely to be systemic nationwide. NWLC found violations that include limiting coverage of breast pump purchases and failing to have lactation counselors in network.
“Denying women certain breastfeeding benefits is a clear violation of the law, and women are experiencing the consequences every day,” said Gretchen Borchelt, NWLC Vice President for Health and Reproductive Rights. “The Affordable Care Act has made dramatic improvements in women’s health coverage. If insurance companies fail to comply, they are illegally blocking further progress toward helping women breastfeed successfully. Everyone involved, from insurance companies to federal regulators, must work together to ensure that breastfeeding coverage fulfills the promise of the ACA.”
In “State of Breastfeeding Coverage: Health Plan Violations of the Affordable Care Act,” NWLC assessed coverage of breastfeeding support and supplies by analyzing coverage offered on health insurance Marketplaces in 15 states during 2014 and 2015 and supplemented this review with stories of real women gathered through the Center’s CoverHer hotline.
NWLC found that some insurance plans put unallowable limits on coverage, such as:
- Only allowing women to get lactation services within two months of delivery.
- Not covering a breast pump until after the baby is born.
- Not allowing women to obtain breastfeeding services out-of-network without out-of-pocket costs when in-network services are not available.
Based on these findings, NWLC is calling on insurance companies to come into compliance with the law and state and federal regulators to provide better oversight and enforcement. NWLC is also calling on federal regulators to consult with stakeholders—breastfeeding experts, the medical community, advocates, and insurance companies—to further develop and enforce federal standards for breastfeeding coverage that take into account the best evidence on helping women establish and maintain breastfeeding.
NWLC secured information on Marketplace plans through online searches and collaboration with state advocates across the country. States reviewed include Alabama, California, Colorado, Connecticut, Florida, Maine, Maryland, Minnesota, Nevada, Ohio, Rhode Island, South Dakota, Tennessee, Washington, and Wisconsin. These states reflect a diverse sample in terms of geography, political environment, and use of a federal or state Marketplace. NWLC also collected information on women’s experiences using their breastfeeding benefits through the organization’s CoverHer nationwide hotline (1-866-745-5487 or firstname.lastname@example.org).