Think all kids will have dental under the ACA? Think again.

***UPDATED: March 11, 2014*** The oral health crisis in America is growing, and it’s becoming especially hard on our youth.  Dental decay is the most common disease affecting kids in our country, with 25% of children ages 2-5 already experiencing cavities.  And while President Obama’s health care law is meant to address the major health issues in America, somehow oral health was not included in the 10 “essential health benefits,” according to a recent US News article. This means that dental coverage will be available through state and federal marketplaces but will not be required, leaving many industry leaders fearful that parents will choose not to purchase it.  Dental insurance typically covers bi-annual trips to the dentist for teeth cleaning, x-rays, fillings and medically necessary orthodontics.  Dental health advocates have continued to work towards a generation without preventable infections, and so established alternative programs, such as the Action for Dental Health campaign movement and “Give Kids a Smile,” that provides free services to thousands of kids nationwide.  The dental problem has been identified as being quite severe in lower income communities, where access to nutrient rich foods is limited and a false fear of dental health still exists.  Experts agree that education is the key in these areas and efforts to bring important services and information will continue, Obamacare requirement, or not.

As the month of February comes to an end, so does the American Dental Association (ADA) sponsored National Children’s Dental Health Month.  Many professionals in the industry have spent valuable time spreading the word about the importance of oral health, especially in promoting it among the youth of America. Habits, after all, are formed at a young age and if we teach our children to respect and care for their mouths, it can lead to a more healthful existence. It ultimately is the job of adults (parents, teachers, dental professionals, etc) to continue with this mission and stress the importance of brushing, flossing, eating right, and visiting the dentist twice a year.   With the passing and implementation of President Barack Obama’s Affordable Care Act (ACA), many were encouraged to hear that insurers across the country will soon be required to offer pediatric dental coverage so that all children have access to great dental care.  But did you realize that even though providers must offer it, consumers don’t have to buy it?

According to a recent ADA News article, if an individual purchases a health insurance policy through an established health exchange, they will be offered the essential health benefits mandated by the ACA, including pediatric dental coverage, but will not be required to purchase them.  Recently, a final rule establishing the standards to be applied to both exchanges and insurance companies was settled, allowing issuers of qualified health plans to exclude pediatric dental coverage if a stand-alone dental plan is offered in the exchange.  There is nothing in the rule that requires an individual to purchase the full set of benefits, therefore it is ultimately up to the consumer whether or not they buy dental coverage, for themselves or their children.  Unfortunately, there are still many people in the world that view dental coverage as optional, and there is a very real fear that when given the choice, individuals will pass on dental coverage in an effort to save money.  Like so many other wrinkles in the new health care reform law, it will take time to iron them all out.  Only then will we be able to see where good intentions fall short and improvements still need to be made.
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