McHENRY – Breast-pump maker Medela Inc. added a third shift of workers this year to increase production following a surge of orders set off by a provision in the Affordable Care Act.
Under the health law, insurance companies are required to cover, without copay, the cost of breast-feeding devices and lactation counseling along with other preventative health services.
McHenry-based Medela is an industry leader on both sides of the business – making breast pumps that mothers buy and use to provide breast milk to their babies, as well as sales and services to the hospitals and clinics that work with mothers as they initiate breast-feeding.
So far, Obamacare has been a boon for Medela, which has more than 600 employees in McHenry and is among the county’s largest employers. The company has seen a “significant increase” in demand for its products, said spokeswoman Claudette Yasell. As a result, it has ramped up production to meet that demand.
It remains to be seen how the coverage mandate could affect the breast-pump market going forward. Some pumps can cost more than $300, but insurance companies have set limits to what they will cover.
The requirement could help encourage mothers to breast feed or help them to breast feed for a longer time, said Dr. Brian Money, a pediatric hospitalist with Advocate Good Shepherd Hospital in Barrington.
“Any time you can advocate for breast-feeding, it’s a good thing. The health benefits of breast-feeding, for both the mother and child, are well-documented,” he said. “Having access to a breast pump shouldn’t just be a luxury.”
Manual breast pumps are less expensive, but can be tedious and difficult. Many women prefer electric pumps, Money said.
The insurance coverage rule, which went into effect Jan. 1, doesn’t specify what types of pumps or brands must be covered. As a result, insurers have come up with a variety of different policies and coverage benefits, according to research done by Medela on behalf of its customers.
Blue Cross Blue Shield of Illinois, the state’s largest insurer, covers manual, electric and hospital-grade pumps with some limits and restrictions, according to a company memo. It will cover the cost of purchasing an electric breast pump as long as it is purchased from an in-network provider or contracted durable medical equipment provider.
Many mothers are taking advantage of the benefits, said Stephanie Uhr, a lactation consultant at Centegra’s Breast Feeding Resource Center in Woodstock.
Breast-pump sales at Centegra are up 40 percent so far this year because of the health law, Uhr said. Lactation consultations have jumped by about the same percentage.
“We’ve definitely seen an increase in demand for pumps,” she said. “More mothers are coming in for consultations as well.”
Prior to Jan. 1, few insurance policies covered breast-feeding equipment, Uhr said. Because the mandate is relatively new, getting pumps for new mothers can be difficult.
“There’s lots of back and forth with the insurance companies,” Uhr said. “We’re hoping the process will get better next year.”
Even so, mothers are “ecstatic” about the benefit, she said. It’s promoting breast-feeding and making it easier for women to continue to the practice after maternity leave.
“They can breast-feed longer because they have access to the equipment when they go back to work,” Uhr said. “And the longer they breast-feed, the better it is for their health and the baby’s health.”
Breast-pump sales are up more than 100 percent at Lehan Drugs, a pharmacy, compounding pharmacy and medical supply company with locations in DeKalb, Sycamore and Rockford. Last year, before the mandate, Lehan Drugs sold about $20,000 worth of breast pumps. Last month alone, the company sold $10,000 worth, said DJ Larson, who works in provider relations at Lehan.
Insurance coverage limits have left many mothers frustrated and confused. Most policies cover the pump, but not the bags, coolers, and other accessories most mothers need to pump on the go, Larson said.
“Because mothers have enough going on, we do all the work for them and determine what the insurance company will cover,” he said. “We saw a need here and we’ve made an effort to really help moms through this.”
Lehan Drugs has a lactation specialist on staff to help with the process and has focused on building up this part of its business, Larson said.
It’s not clear how much insurance benefit limits could influence purchasing decisions in the breast pump market.
Larson said some mothers, particularly those who want Hygeia pumps, are willing to pay out of pocket to get the specific pump they want.
About 77 percent of insurance policies have hospital-grade pump coverage. Hospital pumps, which are stronger and designed to last longer, are usually rented. Most insurance companies require preauthorization or a prescription to get this type of pump, Medela’s study found.
The study also found that most policies provide a pump after the baby is delivered. About 60 percent of plans allow for mothers to upgrade to a pump of their choice, if they pay the difference in cost. Seventy-six percent of policies are flexible and allow the insured to chose another pump if they covered one isn’t available. And 96 percent of policies cover lactation support, the research found.
Medela believes the coverage mandate will help mothers who breastfeed. However, mothers need to be proactive about contacting their insurance company to find out about what coverage is available, Yasell said.
The Affordable Care Act could boost breast-pump sales for a one or two years before levelling off above previous levels, Martin Gold, founder of Technology Access Partners, told Bloomberg Businessweek earlier this year.
Global Industry Analysts, a market research company, cited several factors that could increase breast-pump sales in the coming years, including the rising number of working mothers with full-time jobs.
“An important growth driver is the increasing awareness about the benefits of breastfeeding in light of the rising health concerns over the use of infant formula feed,” GIA said in a press release last month. “Other factors driving growth include favorable demographics such as older parents with higher discretionary spends and dual income households. Additionally, the restructuring of the reimbursement policies in the U.S. in January 2013 wherein insurance companies are required to cover cost of lactation counseling and breast-feeding devices is further expected to witness increased adoption of these devices.”
The global market for breast pumps is projected to reach 7.3 million units by 2018, according to GIA’s research.