Starting January 1, 2014 residents of California and Washington who purchase medical insurance through the new federal health plan will be required to buy pediatric dental benefits regardless of whether they have children or not, according to official documents and interviews leading some to believe that dental insurance for children could be mandated in 2014.
These new requirements come alongside the states’ implementation of the controversial Affordable Care Act which goes into effect the beginning of next year. The two states are responding to some questionable language within the bill. The law, which requires that all citizens have health insurance or pay a fine, does not include dental benefits as a part of its “individual mandate”. However pediatric oral care is listed as one of the ten essential benefits that health plans must include when sold to small businesses, families and individuals.
This ambiguous rule has garnered much attention from the ADA which fears that 11 million adults will drop their dental coverage entirely in an effort to avoid paying for pediatric dental services. The US Department of Health and Human Services, which is in charge of issuing regulations on the ACA has yet to give any guidance on this matter.
The ten essential benefits required by the ACA will be sold as a package through a web site that specializes in insurance for the small group market. However, if consumers choose to purchase a different package that does not include pediatric oral care they will be prompted to select a stand-alone dental care plan. Those who do not choose a dental plan will be unable to complete their transaction.
Experts in the field of dental coverage have stated that pediatric dental care is relatively inexpensive and should not be unaffordable for most American families, and small businesses.
The law also includes pediatric eye care as a part of essential coverage.