IRS Vs. Nursing Mothers and Babies: Breast Pumps Still Not Allowable HSA Expense

Viagra can be paid for with pre-tax dollars; breast pumps cannot. If you're scratching your head right now, it's probably not dandruff.

According to a New York Times article today, "the Internal Revenue Service has ruled that breast-feeding does not have enough health benefits to quality as a form of medical care" and will continue to disallow working mothers with Healthcare Savings Accounts (pre-tax dollars employees set aside for use on allowable medical expenses) from using their HSA money on breast pumps and other nursing supplies--despite the alleged goal of federal health care reform to incentivize preventive health care.

That breast-feeding does not qualify as a form of preventive health care flies in the face of respected mainstream health experts--the Marcus Welbys of modern medicine. A Harvard Medical School study, for intance, found, "Current US breastfeeding rates are suboptimal and result in significant excess costs and preventable infant deaths. Investment in strategies to promote longer breastfeeding duration and exclusivity may be cost-effective."

Backing this conclusion is the American Academy of Pediatrics-the leading group of children's doctors in the United States-which officially states there is "unequivocal evidence" that breast feeding protects against the following health problems: bacterial meningitis; diarrhea; respiratory tract infection; otitis media (ear infection); urinary tract infection; type 1 and type 2 diabetes; lymphoma, leukemia, and Hodgkins disease; and childhood overweight and obesity, as well as several other diseases and conditions.

A Germany study reported in Reuters, originally published in the medical journal Pediatrics, found the risk of Sudden Infant Death Syndrome (SIDS) is also significantly reduced by breastfeeding.

"Unquestionably, breast milk is far superior to any formula designed for babies," said Dr. Jane Morton on the AAP website. "The challenge lies in making breastfeeding... a comfortable, enjoyable, and manageable part of the new mother's life."

How Can Working Women Breast-Feed Without Breast Pumps?

It is the manageable part of breast-feeding that challenges mothers who work outside the home and must deal with physical separation from their children, an obstacle that makes it logistically impossible to breast-feed them the traditional way. Working mothers who want to ensure their children receive the healthiest possible start in life by consuming natural breast milk instead of factory manufactured formula rely on breast pumps to express and store their milk during the hours they are apart from their babies.

Is Breastfeeding More Than Just Good Nutrition?

The crux of the argument over whether breast pumps should be an allowable use for HSA dollars, as are prescription medicines (including Viagra) and even denture adhesives, lies in whether breast milk is good nutrition or preventive medical care. Defenders of the IRS decision state that allowing breast pumps to be paid for with pre-tax dollars would open a Pandora's box to other nutritional devices being granted tax-favored status; for instance, one could argue that juicers should be included becaause Vitamin C from orange juice helps prevent scurvy.

That may be true. But the logic behind the federal government's decisions on what working mothers with HSAs can use their pre-tax medical dollars for is likely driven more by lobbyists for formula and pharmaceutical companies wielding adult-sized campaign contributions than what's best for tiny, helpless babies who lack checking accounts.

If the IRS were really concerned about saving the federal government money, it would take another look at the Harvard study which concluded that if 90 percent of mothers fed their infants only breast milk for the first six months of their babies' lives, the net savings in health care dollars would be a whopping $13 billion a year.

Even Scrooge would drink to that.

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