NCL has been advocating for measures to improve the health of women and children since its founding in 1899 and was very concerned to read about the IRS’ decision to deny nursing mothers the ability to use their tax-sheltered health care accounts to pay for breast pumps and other supplies. Read NCL's letter to the IRS.
October 29, 2010
Douglas H. Shulman, Commissioner
Internal Revenue Service
1111 Constitution Avenue, NW
Washington DC 20224
Re: The use of tax-sheltered health care accounts for breastfeeding costs Dear Commissioner Shulman:
The National Consumers League has been advocating for measures to improve the health of women and children since our founding in 1899. We were therefore very concerned to read about the IRS’ decision to deny nursing mothers the ability to use their tax-sheltered health care accounts to pay for breast pumps and other supplies.
According to IRS Publication 502, reimbursable items include those that aid in the “prevention of disease.” The IRS apparently has inexplicably determined that breast-feeding does not help in the “prevention of disease.” The National Consumers League could not disagree more with this determination. We ask that you review and reverse this misguided decision. Indeed, the medical evidence is overwhelming that far more widespread breastfeeding would not only “prevent disease” in the United States, but would save our health care system billions of dollars.
Consider the following evidence about the myriad health benefits to both mother and child of breastfeeding:
- According to a Harvard study published in April of this year, if 90% of US families would comply with medical recommendations to breastfeed exclusively for 6 months, the United States would save $13 billion per year and prevent an excess 911 deaths, nearly all of which would be among infants ($10.5 billion and 741 deaths at 80% compliance)
- The risk of infant death due to Sudden Infant Death Syndrome (SIDS) is lowered, and respiratory infections such as pneumonia, and necrotizing enterocolitis are nearly eliminated if mothers breastfeed their infants until at least six months after birth.
- The US Department of Health and Human Services has found that breastfed infants have a lower risk of contracting ear infections, stomach viruses, atopic dermatitis, type 1 and 2 diabetes, childhood leukemia, and other health problems.
- Mothers also benefit from breastfeeding because of lower risk of contracting type 2 diabetes, breast cancer, ovarian cancer, and postpartum depression (PPD).
- Breastfed infants typically need fewer sick care visits. Congress recently acknowledged the importance of breastfeeding in the landmark health care reform legislation it enacted this year by requiring that workplaces provide women with a private place to nurse or use a breast pump.
- As Dr. Robert W. Block, president-elect of the American Academy of Pediatrics noted in the New York Times this week, “The old adage that breast-feeding is a child’s first immunization really is true ... So we need to do everything we can to remove the barriers that make it difficult.”
We agree with Dr. Block. We need to encourage, not discourage, barriers to widespread breastfeeding. Unfortunately, the IRS determination NOT to allow parents to use their tax- sheltered flex accounts to cover the cost of breast pumps has the impact of further discouraging women from breast feeding and directly undermines what is by every measure a critical practice for improved public health. We ask that you, as IRS Commissioner, review this decision and, in light of the overwhelming evidence, reverse it. We believe the cost of breast pumps should and must be a covered cost in these flex plans.
Thank you for your attention to our concerns.
Sally Greenberg, Executive Director
National Consumers League
Cc: Senate HELP Committee Chairman Tom Harkin
House Energy and Commerce Chairman Henry Waxman
Treasury Secretary Timothy Geithner
Surgeon General Regina Benjamin