While the Affordable Care Act has opened lactation services to
reimbursement, the law itself is very general. The Department of Health and
Human Services has issued no guidelines on what constitutes breastfeeding
services and has allowed each state and insurer to determine its own
interpretation of the law. This has resulted in poor or no policies and
lots of confusion. If mothers are not receiving the lactation care and
services that they need, they should complain to their state insurance
commissioner's office. So should lactation consultants who cannot obtain
reimbursement for their services because they are not licensed. Maybe
registering enough complaints or asking for a meeting with the commissioner
will bring some of these problems to light.

Marsha Walker, RN, IBCLC
Weston, MA

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