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Putting teeth in PPACA

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For every child without health insurance, 2.6 children lack dental coverage, according to the American Dental Association. But we hope that the Patient Protection and Affordable Care Act (PPACA) will begin to change those shocking numbers. 

Under PPACA, health plans will be required to offer pediatric dental benefits starting in January 2014. This will open up coverage to 27 million children who currently don’t have dental insurance. Of those 27 million children, many will be coming into the system with unmet needs and require additional dental services.

What many people don’t know is that dental disease is nearly 100 percent preventable, yet dental caries (cavities and tooth decay) is the most common chronic childhood disease — five times more common than asthma. Children are losing 52 million school hours each year due to dental disease, and poor oral health affects nutrition, speech development and learning during critical developmental years. The earlier a dentist sees a child, the better the dentist is able to keep the child healthy. Studies have shown that the age of a child at the first preventive dental visit has a significant effect on dental-related expenditures. 

Under PPACA regulations, the newly established health exchanges are required to ensure that participating dental plans have enough dentists in their network to offer sufficient access to all eligible children. However, while the intent of the  law is to ensure that all children have access to dental insurance, the US Department of Health and Human Services recently issued a ruling that, although consumers are required to purchase health insurance, they will not be required to purchase the essential dental benefit for their children through exchanges. Given the sobering facts about the importance of children receiving proper oral healthcare at an early age, it is imperative that our children receive the dental benefits they deserve.

Today, the majority of small businesses (less than 100 employees) who don’t purchase benefits through exchanges buy their dental policies separately. Ninety-eight percent of Americans obtain dental coverage through a separate, standalone dental policy, and child-only dental policies are not commonly offered; however, in 2014, employers may be forced to change the way they obtain coverage. Healthcare reform serves as an opportunity for businesses to reevaluate current insurance plans and explore new options for employees. As businesses make those decisions, they should remember that oral health is part of overall health and be sure to add dental insurance to their benefit package.

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