It’s hard to believe, but insurance coverage for breastfeeding support is some of the best around. It’s changing the game for families and for lactation consultants, increasing breastfeeding success and fueling viable careers. We have The Lactation Network to thank for much of it.
Who is The Lactation Network (TLN)? Legend has it, they started by providing breast pumps through insurance. It’s hard to believe, because today they have successfully done what lactation consultants found impossible for years–making insurances comply with the Affordable Care Act (ACA) to pay for lactation care.
Today, TLN is active in all 50 states, meaning they are collecting from insurance companies to pay IBCLCs working in every state in the nation. If they’ve secured a contract with your insurance company, all of your visits are fully covered. In doing so, they’ve brought not only lactation support, but continuous care through the postpartum period within reach of a vast number of families across the country. That’s no small feat.
Lactation care, codified
Passed in 2010, the ACA obligates insurers to pay for preventive care with no cost sharing. In other words, they cannot charge copays, coinsurance, or deductibles for said services. And guess what? With the innumerable protective benefits breastfeeding confers on babies and mothers, lactation support falls under the preventive care umbrella. The ACA also states that breastfeeding education and consulting must be available before and after birth, and for the duration of breastfeeding.
That means prenatal appointments and continuity of care, baby. The drafters of this bill recognized that one visit in the hospital before you’re on your way does not make for successful breastfeeding.
The ACA was passed in March of 2010, but for years, insurance companies refused to reimburse for lactation services unless they were provided by a licensed professional–and lactation consultants have no licensure. This effectively blocked implementation of the ACA, leaving breastfeeding support providers furious. A few states ultimately passed laws to license IBCLCs and circumvented this requirement, but creating licensure is a long and arduous process that was not broadly replicable.
Enter TLN
To be honest, I don’t have any idea how they did it. I wanted to interview them for this article so I could tell the full story, but they were unable to provide me one. And you know what, I’m not even mad. They are very busy kicking ass, and I’m simply thrilled that they exist! Here’s what I do know, though.
They billed for their first consultation in 2016, and have billed for 300,000 visits since–almost 3,000 visits a month, on average. I would assume that’s much higher today, as this network has grown every year. Impressively, 70% of TLN parents exclusively breastfeed for six months, as recommended by all major bodies governing children’s health. That’s compared to just 25% in the U.S. at large.
This is a great time for an uplifting promotional video.
Fortifying the profession
The implications of this for the quality of lactation care are enormous. As income grows more reliable and predictable, lactation consulting becomes a viable career path for more of those passionate about this care. Livelihoods can be sustained in multiple arenas–not just within hospitals and larger institutions, but in groups and private practices where individuals are free to pursue their unique areas of interest, and will encounter a broad array of issues over the longer term.
Those who choose this path can afford to stay in it longer, and with a greater volume of clients, enhancing their expertise more rapidly and for a greater duration. With this happening nationwide, the effect on the profession is exponential.
I’ve watched this transformation take place since I began supporting families with breastfeeding as a lactation counselor in 2016. I did home visits, but it was all self pay. Insurance coverage was a distant dream, and its absence a sore and grating frustration for everyone involved. For the most part, I only saw affluent families who had the disposable income, and at that, usually only once. Breastfeeding support after the hospital was a luxury, not an expectation.
TLN hit this square on the head with their tagline: “Lactation care is not a privilege, it’s a human right,” and the contracts they negotiate reflect that core value. While coverage varies from state to state, here in Delaware what I have seen is zero out of pocket cost for clients, two prenatal sessions, and as many postpartum visits as desired. For consultants, the compensation is appropriate and timely. We get paid before TLN collects from insurers, stabilizing our practices with secure income.
I know. They’re incredible.
We salute you, TLN!
This blog is a tribute to TLN for making lactation care a human right for thousands of families across America. They’ve made it possible for someone like me to build a life around this profession, and as an independent practitioner who is unbeholden to the demands of a corporate employer. I am free to shape care with my clients as we jointly determine is best, and to give them as much time as they need.
Thank you for going out there and making it happen, TLN. You’re changing lives.