There may be nothing to smile about when it comes to dental coverage and the Affordable Care Act. In fact, some argue dental coverage was all but ignored in the sweeping health-care overhaul.
The law does incorporate provisions for children’s dental services as an essential health benefit, but it includes no additional coverage for adults, according to American Dental Association president Robert Faiella. Dental health advocates were also disappointed that services such as cleanings and sealants were omitted from the children’s preventive benefits that insurers must cover at no cost to patients.
“The ACA really falls short on adult coverage in dentistry,” Faiella said. “The dental side is not really addressed.”
The closest the law comes to addressing dental coverage is requiring small business employees who enroll their children in their company health plan to also enroll them in ACA certified dental coverage – whether or not their employer contributes to the cost.
On some insurance exchanges, dental plans will be sold separately, so consumers who purchase a health plan can decline to add dental for their kids without facing a penalty. Medical plans are required to cover children’s dental services if the exchange does not offer stand-alone dental plans. “Because it’s not a required purchase, fewer private dental plans will be purchased,” Faiella says. “That is what we’re concerned about.”
The exchanges will sell adult dental plans, though the government is not providing subsidies for them.
Adult dental coverage has suffered in the past decade, while more children have received benefits, according to the ADA.
- The percentage of adults going to the dentist has dropped from 41% in 2003 to 37% in 2010
- The number of emergency room visits for dental problems almost doubled to more than 2 million between 2000 and 2010
Oral health provides clues about your overall health and is a critical component of preventative care – leading many oral health professionals disappointed at the lack of attention dental coverage received with the Affordable Care Act.