When her first baby was born, Becky Bormann relied on a hand-me-down breast pump.
At $250, the model she wanted cost more than she and her husband could afford, but the used pump didn't work well and Bormann and her daughter, now 3, struggled.
"My supply very quickly diminished," the 32-year-old told The Huffington Post. "It wasn't until many months later [that I realized] it was because of the lack of power the used pump had. I almost drove myself crazy."
In March, Bormann will have another baby and she still has her sights set on the pump she originally wanted. But this time she is hoping to get it for free.
"I was told to have my OB-GYN write a prescription for the pump, bring it to the medical store located within my clinic or hospital and they would give me the pump and bill our insurance company for the cost," she said. "I won't need to pay anything out of pocket."
Free birth control has gotten the most buzz of any women's health provision in the Affordable Care Act, but the law also requires most private insurers to cover breast pumps and lactation counseling. The aim is to reduce any barriers to breastfeeding, including the high cost of buying or renting a breast pump, which can run up to $400 or $80 per month, according to Susan Burger, president of the New York Lactation Consultant Association. Though the benefit kicked in for new private insurance plans in August, many women only just became eligible Jan. 1.
"What this [provision] says is that breastfeeding is a real part of the health care continuum," said Alison Stuebe, an OB-GYN and assistant professor of maternal and child health at the University of North Carolina. "It is not gratuitous, and it's something that all women should have access to and support for. I think that is a huge step forward."
However, exactly how this will work at a practical level is still being ironed out, she said.
Courtney, 32, who lives in New Jersey and asked that only her first name be used to protect her privacy, heard from friends that breast pumps are now covered and called her insurance company.
"They said, 'Sure, no problem! We just have to send you a list of medical device companies we work with,'" said Courtney, who tried to get a free breast pump last summer. She received a four-page list, but when Courtney started calling, most of the companies didn't make pumps or didn't know what she was talking about.
"By the time I got through 15 to 20 of them, I was desperate," she said, explaining that no one at her doctor's office told her about coverage. "The onus is really on women who have a lot to deal with when you're pregnant and overwhelmed."
Kim Kruse, a 37-year-old who lives in Florida, also struggled to get her insurance company to cover her double electric pump.
"I've spoken with company representatives three times now," she said. "Each time I've been told that my plan will cover a breast pump, but only a manual pump."
"The selection of breast pumps on the website of [the] medical supply company that my insurance works with is pretty slim," echoed Giany Mejia, who has a 2 and a half year old and is due at the end of February. "[It] does not include my first-choice pump."
The breast pump provision does not require insurers to cover any particular model. But pumps are not one-size-fits-all, and many factors go into selecting the best breast pump, including time constraints, transportability and the fit of breast shields.
"What the law is saying is only that insurers have to cover it and with no co-pay," said Debi Ferrarello, a registered nurse, lactation consultant. "It's not specifying what type of pump, and there's a really wide range -- from a manual pump, to a high-end, perfect going-back-to-work pump."
Nonetheless, breastfeeding experts say the law is a great first step in supporting breast feeding and remain hopeful that details about how pumps are covered, and what additional lactation support will look like, come together soon.
"You can't ever evaluate something until it has been around for a while, but we have high expectations that this will increase access to what is needed, for many women, in order to breastfeed successfully," said Dr. Laura Gaydos, an assistant professor in the department of health policy and management at Emory University's Rollins School of Public Health. "This is a very specific piece, but it shows a big shift in the thinking about what basic health care is for women."
Clarification: Language has been added to this article to clarify when "Courtney" had her baby. Language has also been changed to clarify the relative costs of renting or purchasing a breast pump.