CARSON CITY, Nev. (AP) — With an eye on Republican leaders inching toward a plan to replace the Affordable Care Act, Nevada lawmakers considered Monday the first in a series of proposals to enshrine federal health policies in state law.

Former President Barack Obama’s signature health law requires all employers with a staff of 50 or more people to provide a private place and “reasonable break time,” with or without compensation, for workers to extract breast milk.

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Some employers have pointed nursing women to closets to comply with the federal law, Assemblywoman Ellen Spiegel, D-Henderson, told members of the Assembly Health and Human Services Committee.

For that reason and the anticipated federal reforms, she argued Nevada should enact the rule with an additional requirement that the space designated for lactation be clean. Pumping or breastfeeding is essentially preparing food, which comes with health standards, Spiegel said.

“If they’re in there with a pail — a bucket of dirty water, and in a room that’s filled with other dirty chemicals, I certainly wouldn’t want that for a child and I wouldn’t want that for a mom,” Spiegel said.

Healthcare providers and government officials have long promoted breastfeeding for the health of both infants and mothers. But working women — the majority of new mothers in America — are less likely to breastfeed after returning to work because of a lack of time, employer approval, accommodations and milk supply, according to the U.S. Centers for Disease Control and Prevention.

Meghan Trahan, who works at an emergency room in southern Nevada, told lawmakers at the Monday hearing that she was outraged and discouraged when her supervisor told her to use a restroom or janitorial shower whenever she needed to pump milk.

“I told her I didn’t think that was an appropriate place for me to express milk, just like I didn’t feel like it was an appropriate place for her to eat lunch,” Trahan said.

Trahan falls into a group of workers exempt from Obama’s workplace nursing law as well as certain wage laws, which includes hospital workers, teachers, school administrators, truck drivers, farmworkers, fishers, babysitters, seasonal workers, movie theater employees and some in the media.

Nevada Gov. Brian Sandoval said most state facilities currently provide designated spaces for women to breastfeed their infants.

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The same cannot be said for local government buildings, including public schools. Spiegel’s bill would expand the law to cover all public employees in Nevada except those working for the state corrections department.

Opponents to Assembly Bill 113 and school representatives said nursing breaks could be costly. They were concerned “clean” may be too strictly defined and impossible for some employers without expendable space to provide.

As President Donald Trump and Republicans in Congress inch toward a plan to replace certain provisions of the Affordable Care Act, Democratic state legislators across the country are attempting fight or symbolically condemn the new administration’s policies.

State lawmakers in Washington and Hawaii are considering legislation to ban insurers from denying coverage based on pre-existing conditions. Protecting insurance for those individuals is one of the most popular aspects of the ACA, but it’s also an expensive section that will be particularly tricky for Republicans to retain in any reform.

Hawaii lawmakers are considering enacting other provisions of the ACA, too, including banning insurers from instituting lifetime coverage maximums or dropping certain benefits, including pregnancy care.

Other bills in Nevada seek to mandate health insurance companies cover contraception as well as screenings for cancer and autism — both provisions of the federal law.

Sandoval was the first Republican governor to expand Medicaid under the Affordable Care Act, and he has advised caution as Republicans tackle the law. He joined six other GOP governors over the weekend in suggesting Congress let states individually design Medicaid within financial limits. He declined to comment specifically on the Nevada proposals to keep other sections of the law.

“There are portions of the ACA that I will advocate for if they benefit the state of Nevada, but there are also flaws in the law in its current form,” Sandoval wrote in a statement sent Monday to The Associated Press.

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