NADP concerned about health exchange dental benefits

The National Association of Dental Plans (NADP) is spending more than $1 million on a campaign to change a provision in the healthcare law it says will require some people to buy duplicative dental coverage, according to a story in the National Journal.

The NADP is concerned that, starting in 2014, the almost 44 million people who receive pediatric dental coverage through their small business employers will also have to buy coverage through the new health insurance exchanges.

On September 15, the NADP and the Delta Dental Plans Association (DDPA) released "Offering Dental Benefits in Health Exchanges: A Roadmap for Federal and State Policymakers," a 92-page white paper that provides "much needed guidance" to policymakers as they develop the guidelines for medical insurance exchanges required under the healthcare reform act.

Regulatory clarity is urgently needed to prevent disruption of dental benefits for tens of millions of Americans and ensure that they are not required to purchase duplicative dental coverage for their children in exchanges or outside of exchanges in the small group market as part of the Essential Health Benefits Program (EHBP), the NADP stated in a press release.

The healthcare reform act includes "pediatric oral services" as part of the EHBP to be offered in the small group and individual market both inside and outside exchanges, the NAPD noted.

"Without a clarification that medical plans do not have to include pediatric oral services in their policies outside of exchanges and that dental policies consumers currently have can meet the requirements of EHBP both inside and outside the exchanges, the promises made by President Obama and congressional leaders that Americans can keep their coverage and doctors will needlessly be broken for over 40 million consumers with dental benefits through small employers," said Evelyn Ireland, NADP's executive director.

NADP's 2011 Group Purchaser Behavior Study released this month found that most small employers plan to continue their dental benefits when exchanges go into effect in 2014, and as many as 40% of small employers are considering using exchanges to purchase their medical coverage. But whether purchasing their medical coverage through exchanges or outside of exchanges the employees of these small employers will already have dental benefits.

The white paper recommends processes for exchanges to verify and accept current dental coverage so consumers do not have to purchase duplicative coverage and to offer dental coverage to those consumers that don't have it today. It also provides background on the current dental marketplace and offers solutions for state and federal policymakers engaged in exchange design.

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