WASHINGTON - Today, March 5, 2020, the Problem Solvers Caucus formally endorsed the bipartisan Ensuring Lasting Smiles Act, which will close an insurance loophole so that children born with congenital anomalies such as ectodermal dysplasias can get the medically-necessary treatments that they need.
H.R. 1379, the Ensuring Lasting Smiles Act (ELSA) was introduced in the House of Representatives by Reps. Collin Peterson (D-MN-07) and Denver Riggleman (R-VA-05). Problem Solvers Caucus Co-Chairs, Reps. Josh Gottheimer (D-NJ-05) and Tom Reed (R-NY-23) brought the bill to the Caucus for endorsement.
The legislation was recently placed on the consensus calendar and will receive priority access on the House floor by having more than 290 bipartisan cosponsors, thanks to a new House rule the Problem Solvers Caucus fought for early this Congress.
"Too many children born with congenital anomalies are denied coverage for the medically necessary treatment they need in order to avoid long-term physical and psychological injuries," said Problem Solvers Caucus Co-Chair, Rep. Josh Gottheimer. "With the Problem Solvers Caucus coming together to endorse the Ensuring Lasting Smiles Act, we are helping make sure children in need of reconstructive surgeries get the proper health care and treatment they deserve. This bipartisan legislation will help children in North Jersey and around our country grow up healthier and have a greater quality of life."
“Teeth are critical to general health, proper digestion and clear speech,” said Problem Solvers Caucus Co-Chair, Rep. Tom Reed. “The Ensuring Lasting Smiles Act (ELSA) will close a loophole that has allowed insurance companies to routinely deny oral or dental claims for medically necessary treatments to care for our children and families.”
“The Ensuring Lasting Smiles Act is a bipartisan solution that will make real change in the lives of families across the country,” said Rep. Anthony Brindisi. “Holding these insurance companies accountable to living up to what they promise families is a common-sense solution that I am proud to support. With the Problem Solvers endorsement, we can get this done.”
The Ensuring Lasting Smiles Act would address these coverage denials and ensure that children suffering from birth defects and anomalies get the reconstructive treatment they need.
The Ensuring Lasting Smiles Act would address these coverage denials and ensure that children suffering from birth defects and anomalies get the reconstructive treatment they need.
The bipartisan legislation 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.
