A different story in each state: Get tips on covering pediatric dental benefits under ACA

Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health and the author of "Teeth: The Story of Beauty, Inequality, and the Struggle for Oral Health in America." She can be reached at mary@healthjournalism.org.

As state health insurance marketplaces opened for business, Marissa Evans of Kaiser Health News offered a nice consumer-friendly Q&A on pediatric dental and vision care under the Affordable Care Act.

It started like this:

Q: “Will I be required to buy pediatric dental care if I purchase insurance on the exchange?

A: “Most likely, no. Children’s dental care may be included in some plans offered on the marketplaces. But many insurers may offer it as a stand-alone policy, which you are not required to buy under federal law, though people in some states are required to do so. Nevada and Washington state, for example, are requiring this coverage…”

Now there is the rub for health care reporters.

When it comes to the new health insurance exchanges, every state has its own pediatric dental benefits story.

In the next five years, an estimated 3 million children are expected to become eligible to receive private dental benefits through the insurance marketplaces set up by the states. They will be among the approximately 8.7 million children who stand to gain extensive dental coverage through the ACA.

(Another 3.2 million kids are anticipated to get coverage under Medicaid and another 2.5 million through employer-sponsored insurance, according to the American Dental Association. All told, the health care reform law could reduce the number of children without dental benefits by 55 percent, the ADA finds.)

But back to pediatric dental benefits on the exchanges. How is your state coping with the challenges of offering them? And will the benefits result in getting more kids the dental care they need? 

Time – and good reporting – will tell. To help with that good reporting, see this tip sheet on pediatric dental benefits under the ACA and be sure to tune in for today’s webcast, “Will families buy kids’ dental benefits on new exchanges?” at noon ET.

2 thoughts on “A different story in each state: Get tips on covering pediatric dental benefits under ACA

  1. Thiago daLuz

    Our pediatrics clinic in Hope Mills NC has done a lot to help us understand this system and make informed choices. I didn’t realize it varied so much between states.

  2. Pingback: National look reveals gap in access to pediatric dental care | Association of Health Care Journalists

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.