The Ensuring Lasting Smiles Act (ELSA), which requires medically necessary dental procedures be covered for those with congenital anomalies, passed in the House of Representatives.
The Ensuring Lasting Smiles Act (ELSA) passed the House of Representatives on April 4.
ELSA requires that all private group and individual health plans cover medically necessary services resulting from a congenital anomaly or birth defect.
The American Dental Association, American Association of Orthodontists, and other dental groups advocated for this bill, which will now move to the Senate for consideration.
The ADA also initiated a grassroots email campaign that generated thousands of emails from dentists and other stakeholders to Congress.
In the March 31 grassroots action alert, the ADA noted that one out of every 33 children in the U.S. is born with a congenital anomaly — including severe oral and facial defects — that can interfere with breathing, speaking, and eating in a normal manner.
“For many children, specialized surgery is needed, and the procedures are reconstructive since they are performed to correct abnormal structures,” the ADA said. “However, despite the reconstructive nature and necessity of such procedures, many insurance companies consider these services to be merely cosmetic. While they may provide coverage for the preliminary surgeries, insurers will delay or deny follow-up or corrective procedures, including necessary dental treatment, which can have a negative impact on a child’s developmental milestones.”
The ADA said it hopes that the Ensuring Lasting Smiles Act will ensure that all children have coverage for treatment of these anomalies.
The ADA will continue its advocacy to make sure the bill passes the Senate and becomes law.
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