An estimated 5.3 million children are expected to get dental coverage next year through the Patient Protection and Affordable Care Act.
But will up to 11 million parents decide to drop their own dental benefits when their kids get covered separately?
It’s one of the still-unanswered questions surrounding the health care reform law and it worries Evelyn Ireland, executive director of the National Association of Dental Plans, the trade association representing the dental benefits industry.
The problem is this, according to Ireland:
Roughly 23 million children receive dental coverage under their parents’ policies in the small group market. But, beginning next year, the kids’ dental benefits will be duplicated by their medical coverage. While the ACA does not address adult dental benefits, children’s dental services are included as part of the ACA’s Essential Health Benefit package. The EHB is the minimum package of benefits to be offered through exchanges and in the small group and individual market under health care reform. And while large companies won’t be affected by the changes, employees in small groups will have to decide later this year how to get the dental benefits mandated for their children under the ACA.
If they want to avoid the duplication, approximately 22 million parents will need to decide whether to take their children off their own dental insurance. And NADP’s research shows that up to half the parents might consider dropping their own coverage if their children begin getting dental benefits elsewhere.
“Our studies show that when children’s coverage is separated from their parents in the small group market, as many as half of the parents that are currently insured may drop their dental coverage for economic reasons,” Ireland told Donna Domino for a recent story on DrBiscuspid.com.
“We’re looking at potentially 10 to 12 million adults who may drop coverage because they can get their children covered separately. So they may decide to get their kids’ teeth fixed instead. And studies show if adults don’t have coverage, they don’t go to the dentist as often.”
So, while Ireland applauds the increase in covered children, she worries that more uninsured adults could eventually suffer from untreated oral diseases as an unintended consequence of health care reform.
I caught up with Ireland myself while working on a related story. She offered a wealth of background on children’s dental coverage under the Affordable Care Act including a helpful tip sheet “The ACA and Dental Coverage –The Basics” which is available on the NADP website.
Ireland still wonders whether adults will drop their coverage. I called the U.S. Department of Health and Human Services for a comment on her concerns but, so far, have not received a response.