Earlier this month, the U.S. Department of Treasury released a proposed rule clarifying that pediatric dental benefits should be part of the calculation for marketplace tax credits. If implemented, this rule will be a major victory for low-income families in need of access to affordable dental coverage for their children.
Pediatric dental coverage is one of the 10 essential health benefits for marketplace plans that are subsidized based on income level under the Affordable Care Act (ACA).
Unfortunately, the cost of pediatric dental coverage is often not included in the total subsidy amount that roughly 85 percent of those purchasing coverage through the marketplace receive to help pay for the total cost of coverage for their family.
Without the full subsidy to cover all 10 essential health benefits promised under the ACA, many families struggle to get access to dental coverage for their children.
And Congress noticed.
A few months ago, Sen. Debbie Stabenow (D-Mich.) took the lead with a group of Senators who co-signed a letter urging the Treasury to make sure that the advanced premium tax credits under the ACA accounts for the cost of pediatric dental benefits.
The National Association of Dental Plans (NADP) and Delta Dental Plans Association (DDPA) led a coalition of organizations, including DentaQuest, to garner support for Sen. Stabenow’s efforts on this issue.
So, what’s changed for pediatric dental benefits?
The latest proposed rule ensures pediatric dental is included in the subsidy calculation for all families.
Once finalized, this rule will mean that more families have the financial support they need to get the coverage they need to #ExpectOralHealth.
Industry advocates resoundingly supported the announcement. The American Dental Association (ADA), the Children’s Dental Health Project (CDHP), DDPA, and NADP released a joint press release applauding it.
And Sen. Stabenow said:
“For young children, early dental care is especially important, and this decision will help make dental coverage more affordable for families in Michigan and across the country.”
As policies aimed at improving access and affordability continue to evolve, it is equally critical that they are implemented effectively. We are pleased to see the Treasury Department taking steps to ensure that low-income children get access to the dental coverage they need to lead productive, healthy lives.
As health care continues to undergo significant changes, oral health is too important to be forgotten.