Anthem health insurance, which operates as Blue Cross Blue Shield in many states and covers over 40 million people, cut the reimbursement rate for breast pumps by 44% last month, sparking protests and concerns that cost-cutting is coming at the expense of infant health. The unprecedented cut in breast pump reimbursement, from $169 to just $95 will impact the quality of pump moms can receive and the company has already announced plans in Indiana to limit breast pump access to Medicaid customers even further.
The cut hits black families particularly hard because Anthem operates in 15 states, many of which, have some of the lowest breastfeeding rates. For example, in Kentucky, the black breastfeeding rate is 2.2% at six months, compared to 16.6% for white infants. In Ohio, another key Anthem state, the rate is 8.5% for black infants compared to 19.3% for whites.
In Indiana, where Anthem is headquartered, the company changed it policy even more drastically, currently only offering only one breast pump model to Medicaid moms. As of May 22, mothers enrolled in Hoosier Healthwise, Healthy Indiana Plan and Hoosier Care Connect will only have access to one pump—a model that does not even have a portable power supply.
“Having only pump option when all women are not the same, all breasts are not the same and all pumps are not the same is essentially a death knell for continued breastfeeding, said Ryan Karim, RN, IBCLC and president of the Indiana Black Breastfeeding Coalition. In 2015, 19% of people in Indiana were covered by Medicaid and the Children’s Health Insurance Program (CHIP).
“All mothers deserve reasonable options so they can continue providing breastmilk, not to be forced into a dangerous one-size-fits-all approach that makes breastfeeding even more challenging than it already is,” notes Karim, who is a registered nurse and IBCLC. In addition, instead of getting the pump from a skilled lactation counselor who can help them get off to the best start, the pump will arrive in the mail.
The pumps mothers can access via Anthem’s bare-bones reimbursement rate will be of a lower quality in terms of motor type, pump strength, filter and other factors. Lesser quality pumps don’t extract as much milk from the breast or can become incredibly painful, which will inevitably decrease the mother’s milk supply while increasing frustration and disappointment and cutting short the breastfeeding relationship.
“Nationally we are seeing initiation rates among black women hit new highs, but stark racial disparities still exist at the 6-month and 12-month exclusivity mark and access to quality pumps is critical to closing that gap especially with so many mothers going back to work just weeks after birth,” says Kiddada Green, executive director of the Detroit-based Black Mother’s Breastfeeding Association. “ We need more support for feeding breast milk in our community not short-sighted cuts to those who are already burdened that slam the brakes on solid progress,” adds Green, who is also co-founder of the Black Breastfeeding Caucus, a national coalition.
“More than 85% of breastfeeding mothers express breastmilk, most of them using a pump for an extended period of time. A lower reimbursement rate for common electric breast pumps could make it difficult, if not near impossible, for moms to have access to the breast pump most suited for their needs,” says Tina Sherman, Campaign Director at MomsRising, which started a petition urging Anthem to reconsider its decision. The petition has received over 25,000 signatures to date.
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Anthem is cutting access to breast pumps across the board and removing options for low-income moms in Indiana even harder, while it makes record profits. The company recently reported a 234 percent increase in profits to $1.2 billion in the company’s fourth quarter.
However, analysts say Anthem’s move could actually lead to higher health care costs. Moms without access to proper breastfeeding education, quality breastfeeding supplies, and meaningful breastfeeding support tend to have babies who are sick more often, studies show. This means higher costs for payers, including taxpayers.
Study after study has proven that increased breastfeeding reduces medical costs because breastfed children are generally healthier. Recent studies have shown if mothers could meet current medical recommendations for breastfeeding it would save the US economy nearly $13 billion per year in pediatric health costs and premature deaths.
“We need more insurers to step up and prioritize infant health in general and black infant health in particular and not take a how-low-can-you-go approach to the optimal nutrition for babies,” says Green.
Kimberly Seals Allers is a writer, author, and internationally recognized advocate and strategist for maternal and infant health. A former senior editor at Essence and writer at Fortune, she recently founded Narrative Nation, a non-profit that uses narrative-centered multi-media campaigns and technology, co-created by people of color for people of color, to eradicate health disparities. Kimberly’s fifth book, The Big Let Down— How Medicine, Big Business, and Feminism Undermine Breastfeeding was published by St. Martin’s Press in January 2017. Follow her on Twitter @iamKSealsAllers
