The XX Factor

It’s Not Just Free Contraceptives, It’s Free Breast Pumps

Photo by ANDREJ ISAKOVIC/AFP/Getty Images

Yesterday, the Obama administration announced that under the Affordable Care Act, health insurers will be required to pay for a range of preventative care services aimed at women. Not so surprisingly, the news coverage immediately homed in on just one of those measures: free birth control! What you wouldn’t know, unless you scrolled down to the fine print, is that the announcement also covers a slew of other good stuff, including HPV DNA and HIV screening and—this is the part I’m pleasantly startled by—“Comprehensive lactation support and counseling, by a trained provider during pregnancy and/or in the postpartum period, and costs for renting breastfeeding equipment.” Yes, the government is going to make insurers pay for your breast pump rental.  

As a new mother, few things are more crazy-making than realizing—after being told by everyone from your OB-GYN to your baby’s pediatrician to the Surgeon General that you should breast-feed, for reasons ranging from your baby’s health to your bonding with said baby to your own risk of breast and ovarian cancer—that your health insurance plan, the same one that covers Viagra, won’t pay for a breast pump when you go back to work.

Breast pumps are expensive. A small Medela model with a wheezy little motor can cost more than $300; a more efficient, hospital-grade pump appears to run somewhere in the range of $1-3 a day. (The one I chose, the Medela Symphony—universally if anachronistically dubbed the Cadillac of breast pumps—is apparently at the high end.) Whether you rent or buy, over the course of the year that you are encouraged to breastfeed, that pump works out to a good chunk of change—not counting the crazily expensive fenugreek supplements and breast milk storage baggies and all the rest of it. Yes, as the breast-feeding boosters are quick to point out, formula still winds up being more expensive over the long term. But if you are living paycheck to paycheck, when you head back to work, you find that formula is the more affordable choice over the short term.

Which is why, despite my own ambivalence about breast pumps, I’m so excited about this news. Thanks in part to our inadequate maternity leave policies, breast-feeding has, regrettably, become an upper middle-class luxury. No cash-strapped working mother should be told that she is making a choice that may harm her baby’s long-term health, just for want of a breast pump. Those who are skeptical about breast-feeding’s benefits rightly point out that the emphasis should be on may harm—in the absence of double-blind, randomized, controlled studies, it’s impossible to compare breast-fed infants with non-breastfed infants, because breast-feeding mothers and non-breast-feeding mothers are not comparable groups.

That’s true. But until we know that breast milk isn’t better, I’ll look forward to the day when the demographic differences between breast-feeding and formula-feeding mothers are no longer so stark. And who knows, free breast pumps—combined with free lactation consultation—just might help hasten that day. (It’s worth noting that as of 2009, according to the Institute of Medicine, 31 states at least had laws requiring Medicaid to cover pump rentals.)

In the meantime, I’ll wait for Michele Bachmann to catch wind of yesterday’s news. Recall that back in February, when the administration took the much milder step of making nursing equipment tax deductible, the former tax lawyer was seriously ticked off. “I’ve given birth to five babies and I breast-fed every single one,” she told Laura Ingraham. “To think that government has to go out and buy my breast pump. … That’s the new definition of a nanny state.”  

Whatever will she say now that the nanny state actually is making someone buy our breast pumps?