More Than 50 Organizations Sign Letter to Secretary Sebelius Supporting Risk-Based Dental Benefit

This week CDHP sent a letter to Secretary of Health and Human Services Kathleen Sebelius urging HHS to develop a comprehensive, risk-based dental benefit as part of the pediatric benefits package in the Affordable Care Act.  While pediatric oral services were included as part of the essential beenfits in the law, the details of that coverage have yet to be defined. As HHS grapples with clarifying the design of the Essential Benefits Package and Exchanges, CDHP is pleased by the engagement of numerous organizations, speaking as one strong voice in support of a meaningful oral health benefit that is affordable and accessible for kids.

Earlier this year, CDHP along with the Delta Dental Plans of America gathered experts to develop a consensus statement on what the pediatric dental benefit should include in the Essential Benefits Package.  The result is a benefit that focuses on the child.  The statement builds on the existing employer-sponsored dental benefit infrastructure to provide a sound and affordable benefit.  This benefit would assess a child’s risk-factors for early childhood tooth decay, within the context of their family, to identify the appropriate evidence-based care in response to those risk-factors.  The statement reflects the current standards and guidance of the American Dental Association and American Academy of Pediatric Dentistry that recognizes the unique needs of vulnerable children.  By focusing this benefit on preventing tooth decay and providing treatment with the goal of managing the disease, the desire is to avoid much of the pain and extensive treatment costs.  An actuarial analysis by dental insurers determined that this benefit can be provided to all children in the Exchange for less than the current “one-size-fits-all” benefit.

The sign-on letter sent to Secretary Sebelius will provide HHS with the support it needs to structure federal guidance on the Essential Benefit Package toward a more comprehensive, child-focused dental benefit. CDHP greatly appreciates the support of all signing organizations