To celebrate World Breastfeeding Week, this August 4th we’re latching on to your federally-mandated rights to breastfeeding support.
As the biggest insurer in Delaware, Highmark Blue Cross has a big responsibility to get it right. Yet families employed by massive DE enterprises that are insured by Highmark, like Christiana Care, Brandywine School District, and University of Delaware, have lost their federally-mandated access to ongoing breastfeeding support. Although this requirement was written into law by 2010’s Affordable Care Act, in 2025 Highmark still hasn’t made it available.
How We Got Here
It took years for insurers to adapt to the ACA, but a third party payer called The Lactation Network managed to bring most of them into compliance starting in 2016, including Highmark. For the last several years, Highmark’s members had full access to lactation consultants for the duration of breastfeeding, with no cost sharing. More than a few lactation consultants built their practices on this legally-guaranteed insurance coverage of their services.
In May of this year, Highmark and The Lactation Network stopped working together. Overnight, Highmark’s coverage for lactation care disappeared. It has has no International Board Certified Lactation Consultants (IBCLCs) in its network of providers, and states that adding them would be an administrative burden.
When its members submit out-of-network claims for reimbursement, Highmark denies them, requiring deductibles to first be met, and then holds the patient responsible for 40% of the cost thereafter.
Where We Are
We’re once again watching a huge insurance company take our premiums on time without exception and refuse to give us what we pay for. Fifteen years after the passage of the ACA, Highmark still hasn’t figured out how to comply with the law. It has no idea what lactation consultants do or what lactation care is.
Who is in Highmark’s “adequate” network of lactation care providers? When I search in my portal for lactation counseling, I get one pediatric practice within 25 miles. Just for fun, I called that practice and they confirmed that Highmark is quite mistaken–this is not something they specialize in or a service that they offer.
This is Highmark’s idea of “network adequacy” and the basis on which they deny out-of-network claims. It is literally their business to provide appropriate health care services for their members. Yet they are sending mothers to pediatricians–whose patients are exclusively children–for care, and calling it a day.
What We’re Doing About It
I teamed up with with Stephanie Trost of Mindful Motherhood Lactation to campaign for change. We are holding The Letdown Protest on August 4 at 9am in front of Highmark’s offices in downtown Wilmington. We’ll conclude with a latch-on for those with nurslings by 10am.
Whether you have Highmark or not, whether you are breastfeeding or not, we ask that you come out. This is a reproductive rights issue, a women’s rights issue, and a human rights issue. People deserve to have their health care paid for, period. If you’re tired of getting shafted by insurance, stand with us.
The protest is just the beginning. The National Women’s Law Center created a toolkit that includes the law and how it works, sample scripts, and letter templates, and other resources. Using any of these to demand your benefits–or even sharing this information with a friend–brings us closer to our goal of ending #highmarksbigletdown.