Promotion of Breastfeeding and the Patient Protection and Affordable Care ActKaren DeCocker-Geist MSN, CNMFrontier Nursing...
Patient Protection and   Affordable Care Act         On June 28, 2012   The U.S. Supreme Courtissued its ruling to uphold ...
Affordable Care Act Ensures Women ReceivePreventive Services at No Additional Cost• Historic new guidelines that will ensu...
“These historic guidelines are  based on science and existing literature and will help ensurewomen get the preventive heal...
Eight new Prevention Services for Women Now Fully Covered                   BEGINNING AUGUST 2012:  • Well-woman visits.  ...
The Act requires health plans to coverpreventive services for women with no cost sharing, including breastfeeding  support...
“Our Nations public health leaders  have come together to call for realchanges in the policies, systems, and     environme...
The Surgeon General and the  Institute of Medicine both identifythe important role of breastfeeding in       prevention an...
Good News/Bad News• Good: New health plans will need to include these  services without cost sharing for insurance policie...
For Now, Individual Plans and Policies CanDecide How They Will Comply with The Act• The insurance industry has a poor trac...
What Should Plans do to Provide RealEvidenced Based Lactation Care?• Breastfeeding Support• Supplies• Counseling
Comprehensive Lactation Support Should Be Provided by a specialist specifically trained in  lactation medicine and support...
Support During Pregnancy   Prenatal visits include breast inspection and    lactation history   Relevant and accurate ed...
Lactation Consultation Postpartum   Visit at place of birth within 24 hours after delivery   Daily visits in first 3 day...
Breastfeeding Supplies• In special cases such as a preterm, special needs or  seriously ill infant  ▫ Rental cost of a hos...
Why Be Involved if You are NotBreastfeeding?• Lack of breastfeeding increases the risk of acute  and chronic diseases in c...
In 2010, the United Statesincurred at least $13 billionper year in excess costs due topediatric illness because ofsuboptim...
What Can You Do?• Contact your healthcare plan and ask what services  they provide now for breastfeeding mothers• If your ...
The views or opinions expressed in this presentation are solelythose of Karen DeCocker and do not necessarily reflect the ...
References• Childbirth Connection (2012). Transforming Maternity Care. Retrieved       from: http://transform.childbirthco...
Breastfeeding Promotion and the Patient Protection and Affordable Care Act
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Breastfeeding Promotion and the Patient Protection and Affordable Care Act

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Patient Protection and Affordable Care Act and the impact on Breastfeeding Support services now available.

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Breastfeeding Promotion and the Patient Protection and Affordable Care Act

  1. 1. Promotion of Breastfeeding and the Patient Protection and Affordable Care ActKaren DeCocker-Geist MSN, CNMFrontier Nursing University
  2. 2. Patient Protection and Affordable Care Act On June 28, 2012 The U.S. Supreme Courtissued its ruling to uphold the Patient Protection and Affordable Care Act
  3. 3. Affordable Care Act Ensures Women ReceivePreventive Services at No Additional Cost• Historic new guidelines that will ensure women receive preventive health services at no additional cost such as co-pay or deductibles• Standards were developed by the independent group, Institute of Medicine (IOM) Healthcare.gov (2012)
  4. 4. “These historic guidelines are based on science and existing literature and will help ensurewomen get the preventive health benefits they need.” Health and Human Services Secretary, Kathleen Sebelius
  5. 5. Eight new Prevention Services for Women Now Fully Covered BEGINNING AUGUST 2012: • Well-woman visits. • Gestational diabetes screening • Domestic and interpersonal violence screening and counseling. • FDA-approved contraceptive methods, and contraceptive education and counseling. • Breastfeeding support, supplies, and counseling. • HPV DNA testing, for women 30 or older. • Sexually transmitted infections counseling for sexually-active women. • HIV screening and counseling for sexually-active women. Countdowntocoverage.org(2012)
  6. 6. The Act requires health plans to coverpreventive services for women with no cost sharing, including breastfeeding support, supplies, and counseling. Healthcare.gov (2012)
  7. 7. “Our Nations public health leaders have come together to call for realchanges in the policies, systems, and environments that impact breastfeeding families” United States Breastfeeding Committee Chair, Jeanne Blankenship
  8. 8. The Surgeon General and the Institute of Medicine both identifythe important role of breastfeeding in prevention and reducing health care spending. (USBFTF, 2012)
  9. 9. Good News/Bad News• Good: New health plans will need to include these services without cost sharing for insurance policies with plan years beginning on or after August 1, 2012.• Undecided: The rules governing coverage of preventive services allow plans to “use reasonable medical management” to help define the nature of the covered service apply to women’s preventive services.• Bad: Plans will retain the “flexibility to control costs” and promote efficient delivery of care. Healthcare.gov (2012)
  10. 10. For Now, Individual Plans and Policies CanDecide How They Will Comply with The Act• The insurance industry has a poor track record for fairly deciding what is “reasonable coverage”• Undecided means each plan can determine what they will offer under these new rules• What lactation experts will they consult before deciding?• A plan is able to control their costs and meet their own criteria of “efficient delivery of care”
  11. 11. What Should Plans do to Provide RealEvidenced Based Lactation Care?• Breastfeeding Support• Supplies• Counseling
  12. 12. Comprehensive Lactation Support Should Be Provided by a specialist specifically trained in lactation medicine and support services ▫ During pregnancy AND ▫ Postpartum (USBFTF, 2012)
  13. 13. Support During Pregnancy  Prenatal visits include breast inspection and lactation history  Relevant and accurate education  Breastfeeding classes for women and their support people (Childbirth Connection, 2012)
  14. 14. Lactation Consultation Postpartum  Visit at place of birth within 24 hours after delivery  Daily visits in first 3 days of life  As needed for maternal support or health of the baby for 8 weeks post-partum  If medical issues persist:  Support visits until resolution or weaning of the infant  Duration of the first year (USBFTF, 2012)
  15. 15. Breastfeeding Supplies• In special cases such as a preterm, special needs or seriously ill infant ▫ Rental cost of a hospital grade electric pump to use for duration of illness or until weaning• Accessories such as nipple shields when suggested by the Lactation Professional• Prescription medications related to breast infection or breast trauma• For any woman who desires a breast pump ▫ A quality dual electric pump from a leading manufacturer (USBFTF, 2012)
  16. 16. Why Be Involved if You are NotBreastfeeding?• Lack of breastfeeding increases the risk of acute and chronic diseases in children adults• Suboptimal breastfeeding duration: ▫ Significantly contributes to our epidemic of childhood obesity ▫ Increases maternal risks of breast and ovarian cancers, cardiovascular disease, and diabetes (USBFTF, 2012)
  17. 17. In 2010, the United Statesincurred at least $13 billionper year in excess costs due topediatric illness because ofsuboptimal breastfeeding rates. (USBFTF, 2012)
  18. 18. What Can You Do?• Contact your healthcare plan and ask what services they provide now for breastfeeding mothers• If your policy does not offer quality coverage for lactation professionals and supplies ask why• Write and ask for changes to be made based on evidence of better health outcomes• Provide evidence that quality lactation support does save lives and money
  19. 19. The views or opinions expressed in this presentation are solelythose of Karen DeCocker and do not necessarily reflect the viewsor opinions of Frontier Nursing University.
  20. 20. References• Childbirth Connection (2012). Transforming Maternity Care. Retrieved from: http://transform.childbirthconnection.org/blueprint/• Edward Sharpe and the Magnetic Zeros(2012): Song title Mother from the CD Every Mother Counts 2012.• US Breastfeeding Committee (2012). Professional lactation services page. Retrieved from: http://www.usbreastfeeding.org/Portals/0/Letters- Comments/2011-03-07-Joint-Letter-BF-Approp.pdf• U.S. Department of Health and Human Services, Office of Women’s Health, Prenatal Care Fact Sheet (March, 2009) Retrieved from: http://www.womenshealth.gov/publications/our-publications/fact- sheet/prenatal-care.pdf.• Healthcare.gov (2012) Essential Health Benefits: HHS Informational Bulletin. Retrieved from: http://www.healthcare.gov/news/factsheets/2011/12/essential- health-benefits12162011a.html

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