The Affordable Care Act (ACA) mandates that health plans must cover comprehensive lactation support and counseling at NO cost-sharing. This is the law designed to protect new parents.

Blue Cross Blue Shield plans (including CareFirst of Maryland, the Federal Employee Program, Anthem, and Independence Blue of PA) are not meeting this mandate and creating barriers to lactation support.

Instead of building an adequate network of International Board Certified Lactation Consultants (IBCLCs)—the highly trained specialists required for complex lactation cases—BCBS is exploiting legal loopholes by:

1. Refusing to contract with non-RN IBCLCs and rejecting their billing codes. Many IBCLCs are not registered nurses and are therefore blocked from offering in-network services to BCBS families.
2. Directing parents to OBs or pediatricians who often lack the specialized training needed to manage complex lactation issues.
3. Directing families toward limited, online-only services that do not meet many families’ in-person clinical needs.

As a result, Maryland families must pay out of pocket for essential IBCLC care, causing delays in treatment and possibly early cessation of breastfeeding that harms both parents and infants. BCBS must be held accountable to provide care for families in line with their mission to expand health care coverage and remain adherent to the ACA.

We, the signees, are demanding that BCBS include non-RN IBCLCs as in-network providers and fully cover needed lactation support!