One of the lesser-known components of the Affordable Care Act is the availability of dental plans. In addition, dental care for children is one of the 10 mandatory essential health benefits as defined by the law, which means all medical plans must cover pediatric dentistry. Therefore, it is no longer necessary to include your children on an individual dental plan, saving you some money. However, if your children currently see a dentist and you want to keep that dentist, it might be necessary to choose a separate dental plan.
Obamacare dental benefits for children will be provided through the state’s Children’s Health Insurance Program (CHIP) or the MetLife High Option plan that is currently available under the Federal Employee Dental and Vision Insurance Program. This is true for all states except Utah, which will only be providing preventive dental care for children.
Obamacare Dental Benefits Not Mandatory for Consumers
According to federal agencies, the states only have to offer Obamacare dental benefits for children. They do not require parents to purchase them. However, the American Dental Association disagrees with the federal interpretation of the law; however, the federal agency will not require the benefits be purchased in the 36 states where it is operating the exchanges.
Individual states that have developed their own exchanges have the option of requiring dental coverage or not. While they are able to make coverage mandatory for all residents, most states are choosing not to exercise their power at this time. In addition, it doesn’t appear they will be requiring it any time soon, although things can change from year to year.
Impact of the Employer Mandate Delay on Dental Plans
Since approximately 1 million fewer employees are expected to sign up for employer-sponsored health insurance due to the one-year employer mandate delay for companies with 50 or more full-time employees, enrollment in dental plans is projected to decrease as well. According to the Congressional Budget Office, about 500,000 people will go without dental insurance for 2014 because of this delay. The other 500,000 people will likely get coverage through Medicaid or, with the help of federal subsidies, the health insurance exchanges.
Moreover, the decision not to expand Medicaid in 28 states will impact dental enrollment as well. While several states are looking at alternative low-income insurance options, and other states may expand Medicaid in the future, residents in the states that aren’t participating in the expansion will likely see a decrease in dental insurance applications.
Number of Kids and Adults that Will Get Dental Coverage under the ACAWith the inclusion of pediatric dental plans through the Affordable Care Act and the expansion of the Medicaid program in 23 states and the District of Columbia, 8.7 million children will have the ability to gain full dental benefits by 2018. About 3.2 million of those kids will get Obamacare dental coverage through Medicaid, 3 million will get benefits through private health insurance on exchange and 2.5 million will have dental care through their parents’ employer-sponsored plans.
Approximately 17.7 million adults will be able to gain at least minimal Obamacare dental insurance through the Affordable Care Act. Just 4.5 million adults will get full dental benefits through Medicaid, since not all states have chosen to expand the program. In addition, 800,000 adults are expected to purchase private dental insurance plans through the exchanges.
Certainly, the ACA is going to impact children more than adults in terms of dental care. The law is expected to reduce the number of kids without dental insurance by as much as 55 percent. Adults, however, are projected to see an increase in dental coverage of just five percent. In fact, if adults drop their employer-sponsored dental plans because their children no longer need it thanks to the ACA, the number of covered adults could actually decline, leading to an increase in the number of adults who have oral health problems.
More information on specific dental plans offered on different states is available here.