Medical professionals are in near-unanimous agreement that breastfeeding is wildly beneficial for both mothers and babies, which is why the nation's current health care law seeks to support the practice. But after a Republican-controlled House of Representatives voted to approve a bill to dismantle the standing Affordable Care Act (ACA), these essential protections are in serious jeopardy. The GOP's answer to the ACA, the American Health Care Act (AHCA), threatens to roll back the strides that the ACA recently made in ensuring that working women specifically could provide breast milk to their babies. Whether it's true or not, it certainly seems that the conservative architects of the bill have little regard for women's needs, for whatever reason, meaning that breastfeeding rights will likely be affected by the AHCA negatively and severely.
When the ACA, the signature health care legislation of President Barack Obama's tenure, became law in 2010, it offered working women the opportunity to work and express milk more easily and without penalty. It mandated that companies with 50 or more employees provide new moms with "reasonable break time" and a private space that's not a bathroom to nurse or pump for up to one year.
Additionally, any mom who purchases health insurance under the individual market is entitled to breastfeeding support, counseling, and equipment as long as the ACA is in place. That means that breast pumps, for example, are free under the plans.
In its current form, the AHCA does not explicitly discontinue the workplace protections, although there's no guarantee that they would remain intact if the bill were to become law. It's headed to the Senate for approval next, and will likely be altered drastically before those state representatives cast their votes on it. Still, all evidence suggests that a full ACA repeal would strip moms of the breastfeeding protections at work that many of them have relied on for the past few years.
And that's bad news for women and their babies. The United States is the only developed country without federally mandated parental leave, meaning that many women must return to work very soon after giving birth. That can prove to be a barrier for those who with to follow the American Academy of Pediatrics' recommendation that newborns consume nothing but breast milk for the first six months of life.
For babies, this can reduce the risk of sudden infant death syndrome, have lasting health benefits like reduced likelihood of developing diabetes or other childhood cancers, and result in stronger immune systems overall. Moms who breastfeed are less likely to develop conditions such as breast cancer, ovarian cancer, endometriosis, and cardiovascular disease, just to name a few.
The ACA has helped to make that six-month recommendation possible for more and more women. A recent study found that women who had both the time and space to express milk at work were more than twice as likely to still be exclusively breastfeeding at six months postparum, according to Fit Pregnancy. As Katy Kozhimannil, an associate professor of health policy and management at the University of Minnesota School of Public Health and an author of the study, explained to the outlet,
The breastfeeding accommodations written into the ACA were evidence-based, and our research showed improvement in breastfeeding outcomes to those who had access to the accommodations that the law requires. Removing that requirement would negatively impact women's abilities to meet their breastfeeding goals. That is to say, they would be less likely to exclusively breastfeed for six months and more likely to stop with each passing moth, which isn't good for moms or babies.
So that's what's at stake in the event of an ACA repeal. If the AHCA were to pass in its current form, it would grant states the ability to waive insurers' current obligation to provide the ACA's essential health benefits with all plans. Among these are the requirement that women have access to free breat pumps and that they receive that oftentimes-crucial breastfeeding support and counseling after birth.
Simply put, a lot of the progress that nursing moms have enjoyed since the ACA's passage and implementation could disappear. But this is the same bill that would permit insurers to charge women more for plans if they've been raped or have had a C-section, so this is much less shocking than it is infuriating.