Fearful that their industry might be forgotten, dental professionals felt renewed hope with provisions of the new law pertaining to dental care.
My article for National Healthcare Reform Magazine, Drilling Into Health Reform for Dental Benefits, provided information about those provisions.
Between the Supreme Court’s ruling and the presidential election, the dental industry may be chomping at the bit again.
While PPACA supporters cheered the Supreme Court’s constitutionality ruling, there was one notable exception to its stamp of approval – Medicaid funding.
The court ruled funding could not be cut off to states that decide not to follow PPACA’s expanded Medicaid/Children’s Health Insurance Program (CHIP) eligibility.
How does that affect the dental industry?
- PPACA established an essential health benefits requirement, which includes pediatric oral services
- The Court’s ruling essentially makes the expanded eligibility an option of each state
- The Congressional Budget Office (CBO) estimates 6 million fewer individuals enrolled by 2022 as a result of the ruling
Another concern for the dental industry is the definition of essential health benefits.
The Department of Health and Human Services (HHS) acquired the responsibility for defining those benefits. As noted, pediatric oral services is included in the list.
But, which pediatric oral services are covered?
HHS also lobbed that decision over to the states. The states must define their essential health benefits package through a “benchmark” plan from one of the following four categories.
- Small group plan
- State employee plan
- Federal employee plan
- HMO plan
The deadline was October 1, 2012, but like most legislation, deadlines change.
The National Association of Dental Plans (NADP) offers a summary by state of benchmark selections for dental essential health benefits.
As of October 30, 2012, 26 states plus the District of Columbia have taken some form of action.
Another resource for information is State Refor(u)m. The online network for health reform implementation, is an initiative of the National Academy for State Health Policy, funded by the Robert Wood Johnson Foundation.
An article covering the annual meeting of the American Public Health Association (APHA) quoted HHS Regional Director, Herb Schultz.
“A significant amount of dollars will go toward dental services.”
According to the article, Schultz shared that experts project three million children will be covered by 2018 under the pediatric dental care provisions of health care reform.
With the broken state of dental insurance, the dental industry could use the shot of coverage.
The future of PPACA and the decision-making of states is enough to make a dental professional go out and vote in this election.
Notice of Disclaimer –Cathy Miller is not an attorney or health care provider and cannot provide legal or health care advice. The information provided is for your general background only, and is not intended to constitute legal or health care advice as to your specific circumstances. We recommend you review legislation with legal counsel and visit your physician for health care issues.