By Lisa Aliferis and April Dembosky
It was a big debate last summer. While children’s dental coverage is one of the Affordable Care Act’s 10 essential health benefits, the ACA gives states the flexibility to offer the coverage in a stand alone plan. Covered California first required insurers to include children’s dental, then told them to strip out the benefit, in favor of offering stand alone plans at an additional cost.
Now the data is in. Less than one-third of enrolled children on Covered California through 2013 also has dental coverage. Executive director Peter Lee says the additional cost appears to be on issue. ”A lot of folks are low income,” he said. “They’re thinking additional coverage versus food on the table.”
Covered California’s board voted Thursday to make a change. Starting in 2015 all medical plans for children sold through the marketplace will be required to include dental coverage.
Kathleen Hamilton of The Children’s Partnership, an advocacy group, said she was “very pleased, very excited by the 180 degree turn” that the board took.
She said that many people misunderstand how severe dental disease can be in children and its connection to overall medical health. “If kids have dental disease, their nutrition is impaired because they can’t eat properly,” she said. She added that children miss school due to pain and dental infections. The pain may lead to poor sleep — and sleep deprived children have more trouble paying attention in school.
Some dental insurers disagreed with the board’s move. Delta Dental’s Jeff Album says the change will encourage medical insurers to partner with less-expensive HMO dental plans that may have a limited number of providers.
“That means everyone in 2014 in a PPO stands a very good chance of losing their dentist,” Album said. “They’re going to have about half the choice that they have today.”
Hamilton agreed that availability of providers is an issue. She said that Covered California and the Department of Health Care Services, which oversees the state’s Medi-Cal program, still must work “to ensure that networks are adequate and that families have access to dentists in their communities.”
Covered California says it may allow people to buy extra dental coverage if they want to keep their dentist.Related