Requires insurance coverage for lactation support services by a certified lactation consultant who evaluate and manage lactation and infant feeding problems and provide preventative clinical consulting to prevent or minimize the occurrence of potential problems.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A4677B
SPONSOR: Jackson TITLE OF BILL:
An act to amend the insurance law, in relation to requiring insurance
coverage for lactation support services
PURPOSE:
This bill requires that every policy that provides coverage for hospi-
tal, surgical or medical care shall provide outpatient coverage for
lactation consultant services.
SUMMARY OF PROVISIONS:
New York State Insurance Law is amended to include lactation consultant
services as a covered benefit and defines that "lactation consultant"
shall mean an individual who holds the international board certified
lactation consultant (IBCLC) credential who is in good standing, with
the international board of lactation consultant examiners and who evalu-
ates and manages lactation and infant feeding problems and provides
preventive clinical consulting to prevent or minimize the occurrence of
potential problems.
The following insurance law sections are amended:
Section 1. Subsection (i) of section 3216
Section 2. Subsection (k) of section 3221
Section 3. Section 4303
JUSTIFICATION:
The health benefits of breastfeeding to both baby and mother have been
well established and supported by many professional associations includ-
ing the American Academy of 'Pediatrics, American College of Nurse-Mid-
wives, Association of Women's Health, Obstetric & Neonatal Nurses,
National Perinatal Association, La Leche League, UNICEF Infant & Young
Child Feeding & Care, World Health Organization and many others.
While breast milk provides the necessary vitamins and nutrients for a
baby during their early growth and development; racial disparities indi-
cate Black and Latino mothers are less likely to breastfeed their
newborns. Individualized support is critical to establish breastfeeding
during the first few hours and days after a baby is born. Access to
these services can be critical in reducing disparities in breastfeeding
among women of color.
According to data from the Centers for Disease Control, women in commu-
nities of color face barriers when it comes to breastfeeding, including
hospitals serving large communities of color not always offering the
lactation support needed, and women of color more likely than white
women to have to go back to work shortly after delivery and/or not
having enough flexibility in their work schedule to express milk.(1)
The 2019 report by the NYS Taskforce on Maternal Mortality and Disparate
Racial Outcome indicated that mortality rate among women of color was
disproportionately higher in New York State when compared to other
states and countries. (2) The Taskforce recommended ten (10) proposals
to address the mortality rates in New York State, including implementing
training programs for hospitals on racial bias, and promote universal
birth preparedness and postpartum continuity of care. These recommenda-
tions would help reduce the racial disparities through educating provid-
ers and the community in the importance of care during and after preg-
nancy. Education on the importance of breastfeeding in communities of
color, along with hospital policies that support breastfeeding have been
linked to increased breastfeeding in communities of color. This bill
ensures mothers who choose to breastfeed have access to the support
needed to be successful by requiring insurance carriers to cover lacta-
tion consultant services.
LEGISLATIVE HISTORY:
SENATE:
2024: S7126A (Salazar) - referred to Insurance, Amended.
2023: S7126 (Salazar) - referred to Insurance.
2022: S8239 (Salazar) - referred to Insurance.
ASSEMBLY:
2024: A3980A (not a "same as")- referred to Insurance, reported, passed
Assembly.
2023: A3980A - referred to Insurance.
2022: A8653, passed Assembly.
FISCAL IMPLICATIONS:
None
EFFECTIVE DATE:
January 1, 2028
(1) 2020 Breastfeeding Report Card, Centers for Disease Control and
Prevention, https://www.cdc.gov/breastfeeding/datereportcard.htm
(2) New York State Taskforce on Maternal Mortality and Disparate Racial
Outcomes, Recommendations to the Governor to Reduce Maternal Mortality
and Racial Disparities, March 2019
STATE OF NEW YORK
________________________________________________________________________
4677--B
Cal. No. 127
2025-2026 Regular Sessions
IN ASSEMBLY
February 4, 2025
___________
Introduced by M. of A. JACKSON, WEPRIN, ZINERMAN, LEE -- read once and
referred to the Committee on Insurance -- committee discharged, bill
amended, ordered reprinted as amended and recommitted to said commit-
tee -- ordered to a third reading, amended and ordered reprinted,
retaining its place on the order of third reading
AN ACT to amend the insurance law, in relation to requiring insurance
coverage for lactation support services
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Paragraph 10 of subsection (i) of section 3216 of the
2 insurance law is amended by adding a new subparagraph (D) to read as
3 follows:
4 (D) (i) Coverage provided under this subparagraph shall include outpa-
5 tient coverage for comprehensive lactation support services, including
6 services provided by a lactation consultant. Such coverage may be
7 subject to annual deductibles, coinsurance, and copayments as may be
8 deemed appropriate by the superintendent and as are consistent with
9 those established for other benefits within a given policy, unless
10 comprehensive lactation support services has in effect a rating of 'A'
11 or 'B' in the current recommendations of the United States preventive
12 services task force or as provided for in comprehensive guidelines
13 supported by the health resources and services administration.
14 (ii) Nothing in this subparagraph shall be construed to prevent the
15 medical management or utilization review of the services or prevent a
16 policy from requiring that services be provided through a network of
17 participating providers.
18 (iii) For purposes of this subparagraph, "lactation consultant" means
19 a health care professional licensed under title eight of the education
20 law who holds the international board certified lactation consultant
21 (IBCLC) credential and is in good standing with the international board
22 of lactation consultant examiners, who evaluates and manages lactation
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD03999-05-6
A. 4677--B 2
1 and infant feeding problems and provides preventive clinical consulting
2 to prevent or minimize the occurrence of potential problems.
3 § 2. Paragraph 5 of subsection (k) of section 3221 of the insurance
4 law is amended by adding a new subparagraph (C) to read as follows:
5 (C) (i) Coverage provided under this subparagraph shall include outpa-
6 tient coverage for comprehensive lactation support services, including
7 services provided by a lactation consultant. Such coverage may be
8 subject to annual deductibles, coinsurance, and copayments as may be
9 deemed appropriate by the superintendent and as are consistent with
10 those established for other benefits within a given policy, unless
11 comprehensive lactation support services has in effect a rating of 'A'
12 or 'B' in the current recommendations of the United States preventive
13 services task force or as provided for in comprehensive guidelines
14 supported by the health resources and services administration.
15 (ii) Nothing in this subparagraph shall be construed to prevent the
16 medical management or utilization review of the services or prevent a
17 policy from requiring that services be provided through a network of
18 participating providers.
19 (iii) For purposes of this subparagraph, "lactation consultant" means
20 a health care professional licensed under title eight of the education
21 law who holds the international board certified lactation consultant
22 (IBCLC) credential and is in good standing with the international board
23 of lactation consultant examiners, who evaluates and manages lactation
24 and infant feeding problems and provides preventive clinical consulting
25 to prevent or minimize the occurrence of potential problems.
26 § 3. Subsection (c) of section 4303 of the insurance law is amended by
27 adding a new paragraph 3 to read as follows:
28 (3) (A) Coverage provided under this paragraph shall include outpa-
29 tient coverage for comprehensive lactation support services, including
30 services provided by a lactation consultant. Such coverage may be
31 subject to annual deductibles, coinsurance, and copayments as may be
32 deemed appropriate by the superintendent and as are consistent with
33 those established for other benefits within a given policy, unless
34 comprehensive lactation support services has in effect a rating of 'A'
35 or 'B' in the current recommendations of the United States preventive
36 services task force or as provided for in comprehensive guidelines
37 supported by the health resources and services administration.
38 (B) Nothing in this paragraph shall be construed to prevent the
39 medical management or utilization review of the services or prevent a
40 contract from requiring that services be provided through a network of
41 participating providers.
42 (C) For purposes of this paragraph, "lactation consultant" means a
43 health care professional licensed under title eight of the education law
44 who holds the international board certified lactation consultant (IBCLC)
45 credential and is in good standing with the international board of
46 lactation consultant examiners, who evaluates and manages lactation and
47 infant feeding problems and provides preventive clinical consulting to
48 prevent or minimize the occurrence of potential problems.
49 § 4. This act shall take effect on January 1, 2028 and shall apply to
50 any policy or contract issued, renewed, modified, altered or amended on
51 or after such effective date.
