Children’s oral health matters for their whole bodies, and for the rest of their lives. Because oral health is vital to overall health, the Affordable Care Act (ACA) required insurance plans to take a whole-child approach and include pediatric dental and vision benefits into every health insurance plan sold.
That’s why we’re working hard to make House Bill 2467 into state law.
Here’s the problem: Parents face an artificial barrier to affordable dental coverage for their children if their kids do not get their health insurance from Apple Health for Kids.
After the passage of the ACA, Washington State created our own Exchange, a place where people can purchase affordable health coverage or sign up and renew their Apple Health for Kids and Washington Apple Health coverage.
Even though health plans with embedded pediatric dental benefits are allowed in health plans sold outside of the exchange, they are not yet available to families in the Exchange. Instead, families not eligible for Apple Health for Kids who go shopping for coverage on the Exchange need to buy two packages: health coverage and stand-alone pediatric dental coverage. Once purchased, they pay multiple premiums. Finally, they can’t take advantage of an important consumer protection included in the Affordable Care Act, the cap on out-of pocket maximums.
The cap is $12,700, but stand-alone pediatric dental plans are not included, whereas embedded pediatric dental benefits are. Families without embedded pediatric dental benefits included in their health insurance plans must buy separate stand-alone dental plans for each of their children, and each of these carries its own out-of-pocket maximum of $1,000-$2,000.
Embedding pediatric dental benefits is the simplest way to make the most of a family’s limited health care budget—and to ensure uniform insurance standards both inside and outside the Exchange.
HB 2467 passed off the House floor with bipartisan support on Monday, Feb. 10. It is now waiting for action by the Senate, which is needed by Friday, Feb. 28. We are working hard toward its passage.
Please join us. Help ensure Washington families have affordable dental care and consumer choice. Let your senator know that you support family choice and H.B. 2467. It’s good for families, and it’s good for health care.