House Passes the Ensuring Lasting Smiles Act

  • by AGD Washington Advocacy Representative
  • Apr 20, 2022
Last week, the House passed H.R.1916, the Ensuring Lasting Smiles Act (ELSA), by a 310-110 vote. ELSA would require all private group and individual health insurance plans to cover medically necessary services, including dental treatment, for patients with congenital anomalies. AGD endorsed the legislation in a letter to Senate and House sponsors last year.

Most health plans provide coverage for the surgical treatment of congenital anomalies, and many states require insurers to provide coverage of any health services related to congenital anomalies. Despite this, health plans often deny claims and appeals for dental-related procedures, such as orthodontia and implants, by claiming these services are cosmetic or covered by dental plans.

S.754, the Senate version of the ELSA, remains pending before the Committee on Health, Education, Labor, and Pensions.

Impact on General Dentistry: AGD is proud to support ELSA and applauds AAOMS for their leadership of this important legislation. It is critical for patients with congenital craniofacial anomalies to receive necessary reconstructive dental care related to their disorder. These conditions can often exacerbate other oral or systemic health conditions and restrict a patient's ability to breathe, eat, and speak normally. Private insurance currently forces many families to incur significant out-of-pocket costs to access the dental care necessary to treat these anomalies.