Abstract
The Patient Protection and Affordable Care Act (ACA) provides unprecedented federal support for breastfeeding women, support that had historically been afforded through a patchwork of uneven state laws.1,2 The ACA includes two distinct breastfeeding provisions. The first provision, established in March 2010, amended the Fair Labor Standards Act (FLSA) and generally requires employers to provide certain breastfeeding employees break times and private space to express milk during the infant’s first year.2 The second provision, which went into effect in August 2012 for new plan years, requires all nongrandfathered private insurance plans to cover without cost sharing comprehensive lactation support, counseling, and equipment rental.2,3 Coverage by federal and state health insurance marketplace plans became effective in January 2014. Women covered as a result of the Medicaid expansion, currently adopted in 32 states, are also entitled to this coverage.
