ILCA, USLCA and the US Breastfeeding Committee -- and IBCLCs, generally, no
matter what their practice setting -- have been watching, monitoring,
influencing, explaining, advocating about, informing and trouble-shooting
the lactation-related requirements of the Affordable Care Act (ACA, or
"Obamacare") since its required elements started to unfold in January 2013.

Probably the most helpful place to start, regarding *private insurance*
(covering 20% of the insured population in the USA), is the Model Payer
Policy jointly published by USBC and the National Breastfeeding Center, at
http://www.usbreastfeeding.org/LegislationPolicy/ExistingLegislation/ModelPolicyPayerCoverage/tabid/344/Default.aspx

50% of the USA population is Medicaid-eligible; Medicaid requires that
reimbursement be provided only to licensed providers.  No good for
non-licensed IBCLCs UNLESS they are offering care "incident to" that
offered by a licensed provider like an MD.  (The other 30% of the
population has "self-insurance," with the employer paying most workers'
health costs directly, a practice more typical of large employers.  Their rules
under ACA are all over the place)

Note the Model Payer Policy *does* recommend payment to non-licensed IBCLCs
(like me!) for their provision of skilled lactation care, regardless of
whether it is "incident to" MD care. Note too this policy is an
implementation *model,* meaning private insurers will still do whatever
they choose to do.


-- 
Liz Brooks, JD, IBCLC, FILCA (ILCA Pres and USBC Board 2012-14)
Wyndmoor, PA, USA

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