Although the healthcare reform law requires insurers provide dental benefits in plans sold on health insurance exchanges, coverage is often sold separately and is optional for children. Some experts believe this flawed implementation could mean millions of children will lack dental coverage and lead to an increase in tooth decay, which already is the most common chronic childhood disease, reported the New York Times.
"It's letting kids down in my mind, and it is clearly inconsistent with congressional intent," Paul Reggiardo, chair of the American Academy of Pediatric Dentistry's Council on Dental Benefit Programs, told the Times. "The intent was to include all children. Now it only includes some."
It doesn't help that consumers shopping on exchanges don't have to buy dental coverage and don't receive any financial support when they do purchase the benefits. These stipulations likely will prevent about 3 million children from receiving dental benefits by 2018, according to an analysis by the American Dental Association.
What's more, dental coverage isn't created equal on state and federal exchanges, with some exchanges requiring insurers to include dental benefits within health plans and other exchanges allowing insurers to sell stand-alone dental plans.
And since stand-alone plans don't qualify for subsidies like medical plans do, some senators and advocacy groups representing dentists, insurers and consumers have asked the Internal Revenue Service to allow subsidies to apply for dental plans for children.
"The lack of a subsidy could have an influence on the purchase of coverage," Evelyn Ireland, executive director of the National Association of Dental Plans, told the Times, adding that "all of our organizations will push for resolution by early next year."
Meanwhile, a survey from WellPoint found that although older Americans value dental coverage benefits, only four in 10 have dental insurance from an employer, private and/or supplemental plan, FierceHealthPayer previously reported.
To learn more:
- read the New York Times article
- here's the ADA analysis (.pdf)