Members of Congress Urge HHS to Ensure Affordability of Dental Benefits

Parallel efforts led by two longtime oral health champions, outgoing Senator Jeff Bingaman and Congressman Elijah Cummings , a group of nine Senators and 27 Representatives sent letters to Health and Human Services Secretary Kathleen Sebelius today, urging HHS to take action to ensure that families are afforded the full range of consumer protections when purchasing their children's dental coverage under the Affordable Care Act (ACA). The letters, a response to the recently issued proposed rule on Standards Related to Essential Health Benefits, Actuarial Value, and Accreditation, stress that pediatric oral health services are an essential health benefit and should be treated no differently than medical coverage with regard to consumer protections and affordabiltiy. 

Both letters expressed concern that this most recent rule, along with other aspects of the law's interpretation by HHS, treat stand-alone dental plans differently than health plans, creating substantial affordability barriers for many families. Specifically, the rule proposes an additional out-of-pocket maximum for stand-alone dental plans which would result in higher out-of-pocket expenses for families that choose or are forced to purchase their children's dental coverage separately from their medical coverage. The Senators also referenced a 2011 colloquy on the Senate floor during which Senators Bingaman, Stabenow, and Baucus reiterated that the law's intent was not to create different standards for stand-alone dental plans by allowing them to provide this aspect of the essential health benefits package but to create a competitive marketplace with consumer protections fully intact.

Both letters are available for download above.