interesting, Marie, thank you.
further info--  Medicaid rates are very important, as private insurance companies will try to use them as a baseline to negotiate rates.  
I was speaking with ASHA today…..on a particular code, a speech therapist in MA is paid TEN times as much as a speech therapist in AL is paid.  Clearly, the professionals in AL did not do a very good job representing their value when negotiating medicaid rates.  I can say pretty confidently, that  the LC's in NY are going to individually decide to stay out of network rather than accept low rates, because we are already underpaid as it is.  
When professionals refuse to work for less than market value, the insurance companies will be more inclined to start paying market value. 
Also, important to remember, when mothers are paying out of pocket, it is acceptable to charge on a sliding scale after viewing income documentation, but it is not ok to arbitrarily charge people different amounts.
It would be great to continue this conversation with USLCA's involvement, and Susan is putting together a survey.  I want to make sure this forum is not overwhelmed with US talk.  I do think women's fair pay and the value of breastfeeding help are a global issue, though!

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