In Pennsylvania, no new parent should be denied the care their doctor recommends simply because of insurance red tape. In the critical weeks after childbirth, lactating parents often need access to care and support specific to their lactation and breastfeeding journey.
 
While federal law requires insurance to cover lactation counseling and breastfeeding assistance without cost-sharing, many families across the Commonwealth are still unable to access this type of healthcare. In practice, insurers often only cover breastfeeding assistance when it’s provided by a doctor or nurse practitioner with a specific lactation credential, which can be hard to find. This leaves out many qualified providers, including occupational therapists and speech-language pathologist, who are licensed, trained, and already delivering this care. As a result, families are often forced to pay out of pocket or go without healthcare during this critical time.
 
To address this gap, we plan to introduce legislation to ensure insurance coverage aligns with modern, multidisciplinary healthcare practices and expands access to timely, affordable healthcare for families across Pennsylvania.
 
This legislation will:

• Guarantee insurance coverage for lactation counseling and feeding support services, including home visits and therapeutic interventions, without cost-sharing or prior authorization;
• Ensure access to care from any provider who is licensed in Pennsylvania and holds a recognized lactation certification (such as IBCLC, CLC, or CBS);
• Prohibit insurers from restricting coverage based on provider credential or license type;
• Require out-of-network coverage, without cost-sharing, when no in-network provider is available within a reasonable distance or timeframe; and
• Empower licensed professionals, such as occupational therapists and speech-language pathologists, to provide services within their scope of practice.

Pennsylvania families deserve access to care that works for them. This legislation aims to remove barriers, assist qualified providers, and guarantee that insurance fulfills its purpose of promoting health and well-being.
 
Please join us in co-sponsoring this important legislation to support families, improve infant health outcomes, and strengthen access to healthcare across our Commonwealth.