When new mother Amanda Cole launched Yummy Mummy, a New York City-based supply store for breastfeeding moms, in 2009, she had no idea that in just a few years, the Affordable Care Act (ACA) would transform her business into a thriving national retailer.

Since January of this year, Yummy Mummy’s sales have skyrocketed, boosted by a provision in the ACA that requires, for the first time ever, that health insurance companies cover breast pumps. 

“In the first week [of January], my assistant manager was basically just like, ‘The phones are ringing off the hook,’” said Cole, 36. 

But with this boost came new challenges: Cole has not only had to expand operations, but also learn to navigate the complex world of health care.

Getting Into the Health Care Biz

When the Supreme Court legalized the ACA in July, it confirmed that most private insurers, such as Aetna and Blue Cross Blue Shield, had to cover breast pumps.

“I had been researching the implications it would have for my business,” Cole said. “I just thought it would be really important to be aligned with the insurance companies so that moms could get their pump from my store once the law went into effect.”

So, Cole pounded the pavement to make Yummy Mummy an insurance-backed health care provider, and signed her first deal with Aetna before the end of 2012. For the Yummy Mummy customer, this suddenly meant that, depending on members’ plans, Aetna would cover all or a portion of the retail $250-$300 breast pump purchase.

The Boost

While the breast pump provision in the ACA went into effect in August 2012, most women waited to purchase pumps until January 1, when the majority of insurance plans rolled over.

Though Cole won't share sales stats, she said that in January 2013, she served hundreds of breast pump customers--compared to the same time the year before, when she served only 10 to 20 pump customers. And the store's customers, once limited to average Upper East Side moms, are now coming from all over the country. 

“We’re really branching off into a secondary business, because we now have a call center and we just have people manning the phones, taking calls for pump orders all over the U.S.,” Cole explained. “So, before January, we were very much a New York City breast feeding and maternity store, and we had a large clientele, but nothing like what we’re seeing now.”

To match the growth, Cole more than doubled the number of employees to 13, set up the call center in Manhattan, and secured a warehouse in Illinois. She declined to say how she is financing the expansion. 

But with growth comes uncertainty. Cole says she is unsure of how long she can cover the cost of this extra space for the call center and that the company’s customer service may slip through the cracks given the rampage of calls. She says she has recently considered having call center employees work from home to curb the costs.

“I’m learning so much,” she said. “There’s, I’m sure, a lot of unknown that I’ll encounter, and as you grow rapidly, that’s a challenge. We’re up for the challenge.”

A Long Haul

The recent advancements are a drastic change of course for insurance companies, given that, for a brief time during the ACA’s conception, it appeared they wouldn’t have to cover women’s preventive services at all. 

Senator Barbara Mikulski, a Democrat from Maryland, took up the cause and got the Health Resources Services Administration (HRSA) and the Institute of Medicine (IOM) involved to make recommendations on women’s services. The IOM set up a panel to hear testimony about which services to consider.

“The breastfeeding was a new issue that hadn’t been raised before, and my experience was that when I said that as part of my testimony, there was almost a gasp in the audience,” said Judy Waxman, vice president of health and reproductive rights at the National Women's Law Center. “And afterwards, many people came up to me and said, ‘What a fabulous idea, we really hope the panel looks at this seriously, we want to be supportive of that.’”