Thursday, October 27, 2016

Alabama BCBS to Cut Breast Pump Reimbursement

by Glenni Lorick, IBCLC

In a decision that will really hurt Alabama breastfeeding mothers, BCBS of Alabama has decided to lower the reimbursable amount for breast pumps from $220 to $98 effective November 1, 2016. This move is designed to help cut spiraling healthcare costs. However, the cost to Alabama mothers and babies is significant. We already have one of the nations' higher infant mortality rates with a 2015 rate of 8.7 per 1000 live births compared to the national average of 5.8. Only Mississippi had a higher rate of babies dying before reaching their first birthday.

Breastfeeding is the normal way to feed babies. Infant formula, while necessary in some situations is a substandard feeding alternative. In fact the American Academy of Pediatrics recommends breastfeeding as the standard for all infants. Employed mothers are at a distinct disadvantage because in many cases, they are returning to work at just 6 weeks postpartum. The Affordable Health Care Act, however, has mandated that insurance companies provide breast pumps for mothers.

Heretofore, Alabama mothers covered by the state BCBS program have been able to choose between several very good breast pump options including Medela, Ameda, and Spectra, depending upon which Durable Medical Equipment provider they used. This has been a tremendous boon to breastfeeding in Alabama. From 2012 - 2014 our breastfeeding rates went from 57% to 67%. More importantly, however, the number of mothers exclusively breastfeeding climbed 4% from 9% to 13%. It is safe to say that the ready availability of quality breast pumps had an impact on that rate increase.

Just how did BCBS decide the amount that should be allowed? The looked at Amazon. Yep, that's right, Amazon. According to a communication from Dr. Darrell Weaver, Health Director
of Alabama BCBS, they did some price shopping on Amazon and discovered that for about $98 a mother could get an Evenflo pump. Did they get any input from lactation professionals about the quality of that pump as compared to a Medela or a Spectra? Certainly if they had, they would not have made this disastrous decision. Dr. Joshua Johannson, president of  The Alabama Breastfeeding Committee actually wrote a well-researched letter to Dr. Weaver asking him to reconsider this devastating decision. Dr. Johannson is not only a well-respected Ob/Gyn; he is also an International Board Certified Lactation Consultant, so he is well aware of just how necessary a good-quality breast pump is, especially for working mothers. One source to whom I spoke said that Alabama BCBS did not get any input from the national BCBS organization before making this decision.

Please take immediate action by writing Dr. Weaver as well as your state senators and representatives. Ask them not to allow this change to take place on November 1. Together we CAN make a difference.

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