Update on Health Reform Status, Analysis of Breastfeeding Provisions within Senate Bills
Following the House's passage in May of the American Health Care Act (H.R. 1628), a bill aimed at repealing and replacing the Affordable Care Act (ACA), action moved to the Senate, where a more methodical approach was expected. Several proposed bills have emerged in the Senate, however, each has ultimately failed to achieve sufficient votes for passage.
- Better Care Reconciliation Act (voted down 43-57 on July 25)
- Repeal-Only Bill (i.e., no replacement measures included, voted down 45-55 on July 26)
- Health Care Freedom Act (a.k.a., "skinny repeal", voted down 49-51 on July 28)
- Graham-Cassidy Bill (died September 26 as three Senate Republicans announced opposition, and leadership decided not to hold a roll call vote)
Meanwhile, Senators Lamar Alexander (R-TN) and Patty Murray (D-WA), Chair and Ranking Member of the Senate HELP Committee, are known to be drafting bipartisan legislation designed to stabilize the individual health insurance markets created by the ACA.
The USBC has been specifically monitoring action on health reform for the three ACA provisions that directly impact breastfeeding families:
- Breastfeeding Support as a Preventive Service (implementation includes both services & supplies)
- Workplace Breastfeeding Support (requires employers to provide both break time and a private space)
- Funding for CDC Breastfeeding Programs via the Prevention & Public Health Fund (PPHF)
As passed and/or proposed, the bills would not have impacted # 1 or # 2, as these provisions are not subject to repeal under the process of budget reconciliation being used. By eliminating or weakening the Medicaid expansion, however, as well as other sections that encourage individual and employer coverage, the bills would have resulted in a loss of health coverage in general for millions of Americans. Therefore, even if the Preventive Services remained in place for most plans, the newly uninsured would not have access to them. With # 3, the bills would have eliminated the Prevention and Public Health Fund, without any provision to replace it.
Learn more and find links and future updates on our webpage: www.usbreastfeeding.org/health-reform
Zika Exposure Continuing Education Program, from CDC
The Centers for Disease Control and Prevention have partnered with Medscape to introduce a new free continuing education program on U.S. pregnant women and infants with recent Zika virus exposure. The program is intended for infectious disease clinicians, obstetricians/gynecologists, family medicine practitioners, internists, nurses, public health officials, pediatricians, and other clinicians who treat and manage women of reproductive age who may be exposed to Zika virus and at risk for birth defects in their offspring.
National Compensation Survey Data Released, from BLS
The United States Bureau of Labor Statistics has released a bulletin entitled, "National Compensation Survey: Employee Benefits in the United States, March 2017." The bulletin presents estimates of the incidence and key provisions of selected employee benefit plans for civilian workers—workers in private industry and state and local government—by various employee and employer characteristics. The data shows that 15 percent of all workers have access to paid family leave through their employers and 39 percent have paid personal medical leave through an employer's short-term disability insurance program. Five percent of part-time workers currently have paid family leave, compared to 18 percent of full-time workers. Ten percent of employees at smaller businesses (fewer than 50 employees) have paid family leave, compared to 24 percent at large businesses.
Human Milk Storage Clinical Protocol, from ABM
The Academy of Breastfeeding Medicine has released a revised Clinical Protocol #8: Human Milk Storage Information for Home Use for Full-Term Infants, Revised 2017. Breastfeeding mothers may encounter unforeseen reasons for separation from their infants, but more often women express and store milk for planned events, lifestyle flexibility, and returning to work. Knowledge of appropriate human milk handling and storage is essential for breastfeeding success in these situations. ABM clinical protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care.
Action Alert to Support Hurricane Maria Emergency Response, from MomsRising
MomsRising has launched an action alert to urge Congress to appropriate major emergency funding to help Hurricane Maria victims and grant an immediate waiver to the Jones Act (the Jones Act is an obscure shipping law believed to be stalling Puerto Rico's recovery). Almost a week after Hurricane Maria, Americans are experiencing what has been described as a full-blown humanitarian crisis in Puerto Rico and the U.S. Virgin Islands. Some experts estimate that the damage could cost in the tens of billions of dollars and that the recovery could last over a year.
Zika Virus Twitter Chat, from AMCHP
Join the Association of Maternal & Child Health Programs on Friday, September 29, at 1 p.m. ET for a Twitter chat entitled, "An Active Threat: Educating Healthcare Providers and the Public about Zika Virus." Participants will discuss the latest information on Zika for direct health care providers and public health workers. Join the conversation at hashtag #Zikachat.
Two Initiatives Launched to Expand Centering Model, from CHI
The Centering Healthcare Institute has announced the launch of two major growth initiatives to rapidly scale the Centering model in the communities where group care can have the greatest impact. The first initiative will be a grant program offering technical assistance and implementation services to 130 eligible sites, primarily federally qualified health centers and community health centers. In addition, CHI will establish two new regional offices and place staff in key states to better support Centering practices and focus on stakeholder and payer engagement. CHI will partner with two exemplary community health centers to host the regional offices and to help pilot innovative applications of the Centering model.
International Report on WHO Code Violations, from IBFAN-ICDC
The International Baby Food Action Network has released the 11th Global Monitoring report, "Breaking the Rules, Stretching the Rules 2017 (BTR 2017)." The report is a compilation of marketing practices from around the world that have violated the International Code of Marketing of Breast-Milk Substitutes over the past three years. The report includes almost 800 legally-vetted entries on 28 companies from 79 countries as well as marketing trends, Code-related news, and "Look What They're Doing Reports" on Cambodia, China, Egypt, Latin America, Moldova, Russia, Turkey, USA, and Vietnam by selected companies.
Report on Exclusive Breast Milk Pumping, from Breastfeeding Medicine
The journal Breastfeeding Medicine has published an article entitled, "Pumping Milk Without Ever Feeding at the Breast in the Moms2Moms Study." The study participants were women who delivered at Ohio State University Wexner Medical Center in 2011 and completed a questionnaire at 12 months postpartum. Researchers used bivariate and multivariate approaches (survival analysis) to compare women who pumped but never fed at the breast with women who fed at the breast with or without pumping. The report concludes that pumping without feeding at the breast is associated with shorter milk feeding duration and earlier introduction of formula compared with feeding at the breast with or without pumping. Establishing feeding at the breast, rather than exclusive pumping, may be important for achieving human milk feeding goals.
Webinar on State Paid Leave and Paid Sick Days Legislation, from NPWF
Join the National Partnership for Women & Families on Wednesday, October 18, from 2–3 p.m. ET, for a webinar entitled, "Paid Sick Days and Paid Leave in 2017: What We've Learned and What to Expect." The webinar will review legislative wins and challenges of the 2017 session and discuss strategy around emerging trends.
News from the Field
Nutrition Resource for NICU Infant Caretakers, from Hand to Hold
Hand to Hold has released a resource entitled, "NICU Nurturing and Nutrition." The resource was developed for the NICU community to provide information about meeting the nutritional needs of fragile infants. Key topics include infant feeding cues, skin-to-skin contact, breastfeeding, pumping, human milk fortification, and donor breast milk.
Online Data Tools to Support Health Equity Efforts, from PolicyLink & EcoTrust
PolicyLink and EcoTrust have released a new report entitled, "Powering Health Equity Action with Online Data Tools." The report offers ten design principles for creating online data tools that can drive community action for health equity, shares examples of tools that embody these principles, and provides tips for application. The release was accompanied by a Twitter chat that has been compiled into a storify.
Children's Environmental Health Day, from CEHN
Join the Children's Environmental Health Network in celebration of Children's Environmental Health Day on Thursday, October 12. CEHN has published a variety of action tools as well as a toolkit for organizations interested in promoting the event on social media. Join the Children's Environmental Health Day Twitter chat on Thursday, October 12, from 2-3 p.m. ET at hashtag #CEHchat.
#WeMustRise Twitter Storm, from RISE
Join RISE on Wednesday, October 4, from 3–4 p.m. E.T. for the Hispanic Heritage Month #WeMustRISE Tweet Storm. The tweet storm is part of the RISE campaign aimed at increasing civic participation among members of the Latinx community and raising awareness about key policy issues.
Webinar on Intersection of Health and Economic Development, from County Health Rankings & Roadmaps Project
Join the County Health Rankings & Roadmaps Project on Tuesday, October 24, from 3-4 p.m. ET for a webinar entitled, "Improving Health through Equitable Economic Development and Strategic Partnerships." Participants will learn about the intersection of racial economic inclusion and health, as well as how Urban Health Plan in the Bronx is using economic development as a strategy to improve community health.
Collective Impact Connection
Research Report on Insurer Pursuit of Improved Health Outcomes, from FSG
FSG has released a report entitled, "Insuring Shared Value." The report addresses how insurers gain a competitive advantage by better addressing society's needs and includes illustrative case studies to help insurance leaders re-examine their business strategies. The research also offers ideas for how stakeholders can work with insurers to reduce risk and advance their missions to improve society.
News & Views
NACCHO Voice (National Association of County and City Health Officials blog): "Shifting Internal Policies and Systems to Create Breastfeeding Continuity of Care"
Breastfeeding Magazine: "How Formula Advertisements Try to Fool New Parents"
BioMedCentral: "Improving infant health: What's the role for social policy?"