MaineCare coverage of donor milk is the law in Maine

Beginning in January 2023, donor milk will be covered by MaineCare for babies with medical need. Congratulations to Mainers everywhere, especially to the Maine State Breastfeeding Coalition, Rep. Margaret Craven, MaineCare and all who are working so hard to pass and implement this bill. All the parents, babies, and practitioners in the area will benefit in the coming years. Maine and Connecticut are setting an example to the rest of New England for prioritizing equitable access to donor milk.

Maine is joining 14 other states that passed legislation mandating insurance coverage of pasteurized donor human milk. Each law is different, as is the journey from idea to passage to implementation.

Creating the Donor Breast Milk Law

The double passage of An Act Concerning MaineCare Coverage for Donor Breast Milk, the bill itself and budget allocation, involved two legislative sessions and almost three years of hard work and teamwork across Maine and Massachusetts. It began in 2019 when Rep. Margaret Craven attended the opening of Mothers’ Milk Bank Northeast’s first community milk dispensary at Pediatric Associates of Lewiston where she engaged in a lively conversation regarding the importance of MaineCare coverage for donor milk for the state’s most vulnerable babies. A flurry of phone calls and emails later, Rep. Craven introduced the bill into the legislature, and it was assigned to the committee on Health and Human Services.

Over two sessions, HHS committee held two committee hearings regarding the bill. Mothers’ Milk Bank Northeast and Maine State Breastfeeding Coalition worked closely together in calling on Maine’s breastfeeding support community to testify at the committee hearings and contact legislators in support of the bill. We also had the opportunity to provide information for the fiscal note, estimating costs of the bill over several years. As is most often the case, the fiscal note does not include indication of money saved on costly treatments prevented by use of donor milk. Our testimony offered some of this information.

While the bill passed in April 2021, fiscal pressures due largely to unexpected Covid costs, meant it did not immediately receive funding. At the mid-year review, Mothers’ Milk Bank Northeast and MSBFC sent out a call to action asking all of our supporters once again to contact their legislators in strong support of voting for the full allocation.

Calls to action are powerful. Each time we put out a call, the response was quick and vocal. Legislators heard the will of their constituents loud and clear. Congratulations and our deepest thanks to all who responded. Without strong constituent voices, the bill and budget allocation would not have happened.

In April 2022, the bill with allocation was signed into law by Governor Janet Mills.

What are next steps?

1. By Jan 1, 2023 MaineCare must secure approval of their plan from the federal Centers for Medicare and Medicaid Services;
2. Determination of where this law falls in coverage sections. Is donor milk food? Medicine? Or as in many states, Durable Medical Equipment? Each has implications for implementation and coverage;
3. A system by which MaineCare members will access the benefit;
4. Determination of the category for the provider (Mothers’ Milk Bank Northeast).

Each of these steps will take time. Fortunately, MaineCare has invited Maine State Breastfeeding Coalition and Mothers’ Milk Bank Northeast to the table to support their work with our knowledge and the experience in other states. Together, we are looking for ways to meet these requirements simultaneously, rather than one at a time.

We are excited to have reached this stage and are confident that, should another call to action be needed, you will respond with the care and enthusiasm you have shown for the last two years.