Ensuring Lasting Smiles Act

Latest News

The ADA is happy to announce that, with the help of your advocacy, the U.S. House of Representatives overwhelmingly passed the Ensuring Lasting Smiles Act (ELSA), H.R. 1916, on April 4.

 

As you know, ELSA would require all private group and individual health plans to cover medically necessary services resulting from a congenital anomaly or birth defect, including inpatient and outpatient care and reconstructive services and procedures, as well as adjunctive dental, orthodontic, or prosthodontic support.

 

There is still work to do and the ADA will continue to advocate for the U.S. Senate to hold a vote and get this legislation signed into law!

 

Thank you!

Ensuring Lasting Smiles Act in Congress

S. 754/H.R. 1916 would require all private group and individual health plans to cover medically necessary services resulting from a congenital anomaly or birth defect. This would include inpatient and outpatient care and reconstructive services and procedures, as well as adjunctive dental, orthodontic, or prosthodontic support. This bipartisan legislation is crucial to ensure that children suffering from congenital anomalies and birth defects are able to receive the treatment they need.

Background on the Ensuring Lasting Smiles Act

One in every 33 children in the United States is born with a congenital anomaly or birth defect that affects the way they look, develop or function. Many of these congenital anomalies include severe oral and facial defects such as cleft lip or palate, skeletal and maxillofacial deformities, hypodontia (absence of teeth), and enamel hypoplasia. These anomalies can interfere with a child’s ability to breathe, speak, and/or eat in a normal manner. Specialized surgery is needed to correct these anomalies. These procedures are reconstructive in nature and are performed to correct abnormal structures of the body. Despite this, many insurance companies consider these services to be cosmetic, and while they may cover the preliminary surgeries, they will delay or deny follow-up or corrective procedures, including dental work related to the anomaly.

Mother brushing a childs teeth
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