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IRS Rules Breastfeeding Lacks Health Benefits
The IRS has ruled that breastfeeding supplies do not qualify for tax-exemption under the new rules for Health Care Flexible Spending Accounts. Because breastfeeding “does not have enough health benefits to quality as a form of medical care.”
Riiiight. As the Michelle Brandt points out on Stanford’s health blog:
…breastfeeding can prevent the premature death of 900 babies a year – and that same study showed that $13 billion could be saved annually if 90 percent of moms were able to breastfeed exclusively for six months.
How does that stack up against the health benefits of, say, acne medication?
Likening breastmilk to any other form of nutrition, the IRS refuses to grant the tax-exemption for breast pumps on the same grounds they wouldn’t exempt an orange-juicer: it’s not a medical expense.
Except that breast pumps, unlike orange juicers, are pretty much universally sought out by women with a medical need: to care for their infant’s health. I’ve acquired a few breast pumps in my life: they were given to me at hospitals, and paid for by my health insurance. Unlike my orange juicer, which I picked up at a garage sale for 50 cents.
You know why? Because my baby’s doctor felt that me having a breast pump was essential for her care. Unlike the orange juicer, which never came up.
Breastfeeding supplies never qualified as eligible health care FSA expenses. But the health care overhaul is supposed to help lower medical costs by helping families and doctors focus on preventative care. Breastfeeding definitely acts as preventative medicine. The NYT quotes a doctor calling it baby’s first immunization.
Nursing moms will get one benefit out of the new health care legislation: mandatory unpaid leaves from work to pump milk.
That’s great, but we could be doing so much more.
Photo: planet_oleary
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25 Comments
Danielle commented on Oct 27 10 at 12:32 pmI am really wondering why the IRS feels that they are qualified to give a real medical stance on this when they are not a medical group, organization, or medical focused government agency.
It is beyond nonsense that they will actually give assistance to families with GRASS allergies to install different turf in their yards, but not help women get breast pumps?
Talk about priorities being backwards!
bob commented on Oct 27 10 at 12:45 pmDon’t let the sensational headline fool you. This is just an administrative ruling that a breast pump is more like a bottle warmer (or indeed an orange juicer) than a wheel chair when it comes to qualifying expenses that you can use to reduce your income tax liability.
Gretchen Powers commented on Oct 27 10 at 12:56 pmA couple things…you don’t NEED a pump to breastfeed…that said, FSA/HSAs are just fake-outs for what should be comprehensive healthcare in America…and THAT said, if you want comprehensive universal healthcare, you really can’t expect the government to pay for every little thing if you are a working person (non-poor) with some money. The FSA/HSA thing really only means you get to buy the pump with tax-free dollars, anyway, right? While the rationale that breastfeeding “does not have enough health benefits to quality as a form of medical care” seems flawed to me, the concept of breastfeeding being “medical care” at all doesn’t really make sense. It’s feeding your kid, not medical care. This would be the same as vitamins or nutritious foods being eligible for FSA/HSA purchases.
Lynnsey commented on Oct 27 10 at 1:07 pm“You don’t NEED a pump to breastfeed.”
It sure as hell helps when you have to go back to work. Unless YOU were able to take your baby with you.
Plus, I actually did NEED a breast pump in order to breast feed. Initially, we had trouble with my son latching on and the only way he could get enough was if I pumped and gave him a bottle of expressed milk. Without the pump, I would have had to give up trying to breastfeed…instead I went on to nurse for over 10 months.
The evidence of the value in terms of overall impact on the health of babies (and mothers) is vast. Saying that an aid to that end is not “medical care” is splitting hairs at best. Not to mention that in the current economic environment every little bit helps the “working person.”
Gretchen Powers commented on Oct 27 10 at 1:21 pmI’m not making any value judgments on you or your life, just explaining why a government agency that is committed to pretty bare bones stuff…the IRS…wouldn’t allow these to be bought tax-free. Maybe you’re hitting on something that might be a valuable argument, if people could get a doctor or LC to sign off on something that a woman or her baby is having physical problems with breastfeeding, then they could write off the pump. That would make sense. Basically speaking, though, you don’t need a pump.
Lynnsey commented on Oct 27 10 at 1:52 pmYou’re still (or purposely) missing the point. How do you return to work AND continue to breast feed (which has been proven time and again to have great value medically speaking) under most circumstances that working mothers face WITHOUT one?
JEssica commented on Oct 27 10 at 2:02 pmEven OTC medicine is going to be excluded on the FSA/HSA list. How is something with the word “medicine” used to describe it as not on the list shows what this adminstration wants: more taxes.
Gretchen Powers commented on Oct 27 10 at 2:33 pmYou don’t return to work til the kid is older…but that’s a whole OTHA issue…again…I don’t judge people’s choices, but I don’t expect to pay for them either, I just make statements. People do what they must.
Em commented on Oct 27 10 at 5:47 pmIf a breast pump should be tax deductible, so should fresh fruits and veggies.
Hollie commented on Oct 27 10 at 6:36 pmI’m sure the IRS just assumes that women can manually express several ounces of milk into a funnel in the bathroom at work, no pump required :)
Cordelia commented on Oct 27 10 at 9:06 pmThe entire game of what is and is not a ‘medical device’ for purposes of insurance/medicaid and what is or is not tax deductable is indeed insane. The commenter who said that you don’t return to work until kid is older is probably better off arguing that no medical devices should be tax-deductible. If ANYTHING should, then darn tootin’ breast pumps should be included.
Lynnsey commented on Oct 27 10 at 10:37 pmI was fortunate enough not to have to return to work until my son effectively weaned himself. I know, however that this is not the case for most people if they’re lucky enough to get leave in the first place. The answer isn’t going to be found in your not-my-problem attitude (with all due respect…I’ve read enough of your comments to see a trend) but in real changes in how we as a society view motherhood and its importance. Things like this become important in the context of making those changes.
Gretchen Powers commented on Oct 28 10 at 6:56 amPumping your milk is a lifestyle choice, it’s not a medical need. Unless, as I mentioned, you have a medical problem with latching or whatever. If you can’t understand why a lifestyle choice would not be covered by an HSA/FSA, then you need to go back and do a little more reading. You can say “this ought to be” a, b, and c all you want, but you have to do it with some intelligence and consistency. Going to the gym is healthy, too, but it’s not covered…yet. Maybe someday? The way the IRS answered was incongruous, of course, because, obviously breastfeeding has tons of benefits, but its easy to see why a pump would not be covered and hardly shocking. I agree that there may be changes needed in how we view motherhood and its importance. It was important enough to me for me to quit my job and stay home with my kid during her nursing years.
Gretchen Powers commented on Oct 28 10 at 7:08 amYou know what a good program would be? One that would allow people to save pre-tax dollars into an account they could use to live off of while a parent took an extended maternity leave (1-2 years)…the gov would provide job protection under the law and people could pay into a program, tax-free, interest-earning, to fund their leave…
jenny tries too hard commented on Oct 28 10 at 9:06 amPumping milk sure as hell wasn’t a lifestyle choice when it needed to go through a feeding tube to get to my premature babies…or when my daughter needed surgery and couldn’t take fluids by mouth…
Gretchen Powers commented on Oct 28 10 at 9:09 amsigh…….”Unless, as I mentioned, you have a medical problem with latching or whatever.” I think your situation would be covered under the “or whatever” part. A *medical situation*…sigh.
jenny tries too hard commented on Oct 28 10 at 9:30 amThe IRS doesn’t agree, though, GP, that’s the freaking point.
renee commented on Oct 28 10 at 9:44 amIf you need a pump for medical reasons, your health insurance (including Medicaid) should pay for it, so the HSA/FSA should be irrelevant (and no one who is uninsured has an FSA). The only way you could include your pump on your FSA, assuming you’re one of the minority of people who have FSAs in the first place, would be if you knew you were pregnant and would need a pump before open enrollment in November, and budgeted for the $250 or whatever at that point, and then you would be able to buy the pump with pretax dollars. The number of people to whom this would apply is minuscule. This is really a silly argument.
jenny tries too hard commented on Oct 28 10 at 10:31 amMy insurance didn’t cover a pump; it was the kind I found best for my family, a flex account with a high-deductible plan. We covered the basics (like a pump, which I used for work and for Mary’s hospital stays). The larger point is that the government regulating the you-know-what out of FSAs is ridiculous and counter-productive.
michelle commented on Oct 28 10 at 11:16 amGretchen, you are pretty judgmental. Whatever makes you feel better, I guess.
Gretchen Powers commented on Oct 28 10 at 11:32 amI’m judgmental because I am not in a huff about people not getting breastpumps with tax-free dollars? I would disagree. I don’t have anything against people who pump, people who work when they have infants, etc. But, that’s a choice they make. That’s their choice. But, it is most certainly a lifestyle choice in the vast majority of cases to do so. Philosophically, though, you hear alot of talk about the importance of mothering from people and then these people leave this important thing to someone else all day long. There is a little bit of a disconnect there, in my opinion.
michelle commented on Oct 28 10 at 12:01 pmIt’s needlessly judgmental to blame the mothers rather than think about what pushes them to make the “choices” you so disapprove of. We don’t really have all that many choices. You imply that many mothers choose to leave their babies with someone else because they just don’t feel like mothering. There is no evidence for that, but plenty of evidence that mothers feel terrible about it and wish they could be with their children more. I think all too often people would rather not think about the reasons why we have the parenting crises we do. Just a sample: a still-broken healthcare system (thereby making a minor benefit like pretax savings accounts much more important than they should be), stagnant income growth over the past 30 years (while cost of living continues to rise) that have made 2 incomes necessary for most families to afford life in a decent school district. I could go on. Yes, I get why the IRS ruled the way it did. It’s probably right from a technical standpoint. I am saying that tax exemption is not really a solution for anything anyway. I think generally people don’t like to deal with tougher issues when it’s much easier to just blame women for their “choices.” I also think, by the way, that it makes no sense to say you don’t expect to pay for someone else’s choices. We all pay for other people’s choices, all the time. Curious that most people are fine with this when we’re paying, for example, a private insurance company for other people’s choices, but somehow a government program is just unacceptable.
Manjari commented on Oct 28 10 at 6:04 pmMy friend buys contact solution with her FSA. Aren’t contacts a lifestyle choice? I don’t get how these decisions are made.
Gretchen Powers commented on Oct 29 10 at 10:11 amI don’t think government programs are unacceptable. I actually proposed one. And, I’m not blaming women for their choices. Hopefully these choices are made by both men and women, both parents (or both same-sex parents, if that’s how you roll). All I am saying is that this particular bene doesn’t make sense…just like you say when you say “I get why the IRS ruled the way it did. It’s probably right from a technical standpoint. I am saying that tax exemption is not really a solution for anything anyway”
Here’s another view that I feel aligned with: http://bfmed.wordpress.com/2010/10/27/why-i%E2%80%99m-conflicted-about-breast-pumps-and-flexible-spending-accounts/
Sarah commented on Oct 29 10 at 3:34 pmI haven’t read all the comments yet – but I’d just like to point out that currently most health insurance companies dont cover pumps – but if you get a prescription for the pump than it does qualify. And I haven’t met a doctor who wont give a prescription when you ask.
It is a pain in the butt – you have to buy it through the pharmacy – but it will qualify then.
Also – this is NOT a change – from the article it states that they are just continuing their previous ruling…
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