What has been the effect of the Affordable Care Act (ACA) on breastfeeding rates in the USA? Now that the ACA is in jeopardy because of the new administration, we need to ask ourselves whether it mattered anyway.
The ACA mandated that private health plans cover the cost of lactation support services, including a visit with a lactation specialist and breastfeeding durable medical equipment, with no cost sharing, such as copays or deductibles. The coverage began in August 2012 for all health plans except for those private plans that were grandfathered in. The goal in mandating such coverage was to increase breastfeeding rates and to decrease the risk of infant and maternal illness over the long run as an outcome of increased breastfeeding rates. In addition, breastfeeding success often depends on access to lactation specialists and pumps, both of which are less affordable for low income families. The mandate to cover lactation support services would address breastfeeding disparity due to lack of access to resources.