Today, Rep. Cindy Axne (IA-03), Rep. Anna Eshoo (CA-18) and a bipartisan group of members reintroduced the Ensuring Lasting Smiles Act, legislation to ensure health care coverage for Iowa children suffering from rare genetic disorders and birth defects. The bipartisan legislation would close a coverage gap by requiring insurance companies and health plans cover serious dental and oral procedures needed to treat congenital anomalies, or birth defects.
Many insurance companies deny access to care by labeling these necessary procedures as cosmetic, and the denial of these services will lead to long-term physical and psychological harm. The Ensuring Lasting Smiles Act would close a loophole that has allowed private insurance companies and health plans to deny coverage for medically necessary procedures to treat congenital anomalies.
“There’s nothing ‘cosmetic’ about ensuring children suffering from genetic disorders can chew, swallow and speak,” said Rep. Axne. “These are necessary medical treatments, and parents shouldn’t be on the hook for thousands of dollars in out-of-pocket costs just because insurance companies won’t cover them. I’m proud to once again join this bipartisan effort to ensure every child in Iowa gets the care they desperately need at an affordable price.”
Specifically, the Ensuring Lasting Smiles Act would:
- Ensure that all health plans cover medically necessary services, including reconstructive surgeries and oral-related procedures, as a result of congenital anomalies or birth defects;
- Stipulate that such coverage include services and procedures that functionally repair or restore any missing or abnormal body part that is medically necessary to achieve normal body functioning or appearance, and clarifies that this includes adjunctive dental, orthodontic or prosthodontic support; and
- Exclude cosmetic procedures or surgery.
Rep. Axne has been an advocate for the Ensuring Lasting Smiles Act since hearing the stories of Jennifer Steele and Sarah Ward, two moms from Dallas County, Iowa. Their children, Alli Steele and Amelia and Lucas Ward, all suffer from ectodermal dysplasias, a group of rare genetic disorders where a child’s teeth, skin, hair, nails and glands develop abnormally. The moms discussed the serious physical and mental issues associated with missing and mis-shaped teeth, including chewing, swallowing, digestive, speech and self-esteem issues. While the Steele and Ward families have health care, they are forced to pay thousands of dollars of out-of-pocket costs because insurance companies refuse to cover medically necessary services.
The Ensuring Lasting Smiles Act had over 300 bipartisan co-sponsors, including Rep. Axne, in the 116th Congress.