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Federal Government Could Make Children’s Oral Health Insurance More Affordable

By Cheryl Fish-Parcham,


Oral health care is vital to a child’s overall health. This summer, the U.S. Treasury Department proposed a change in the rules for financial assistance in the health insurance marketplace that, if adopted, will make children’s dental care more affordable.

Getting pediatric dental care often requires buying additional health insurance

Pediatric dental care is one of the essential health benefits that the Affordable Care Act marketplaces must make available to children. However, unlike other essential benefits, pediatric dental care is often provided through separate stand-alone dental plans.

This means some families must buy dental coverage in addition to insurance they buy through the marketplace to cover their children’s other health needs.

Government would change how marketplace financial assistance for consumers is calculated to account for dental plans

This summer, the U.S. Treasury Department proposed a change in the rules for premium tax credits to ease the financial burden on families buying children’s dental care.

The proposed rule will ensure that the financial assistance families receive from the marketplace to help them pay their monthly health insurance premiums will factor in both their regular health plan and the cost of a stand-alone dental plan.

Right now, premium tax credits do not account for the cost of stand-alone dental coverage.

How would this work? If the rule is adopted, the premium tax credits that consumers receive would account for the combined cost of a silver level health plan that does not provide dental benefits and the cost of a stand-alone dental plan.

This would be a helpful change—increasing the financial assistance to families purchasing both plans so that the overall cost of covering a child’s health care needs will be affordable.

Treasury department’s rule shows importance of oral health to overall health of children

The proposed rule is welcome recognition that oral health care is vital to a child’s overall health and must be more affordable. The United States has set goals for reducing dental cavities among children as part of a federal initiative, Healthy People 2020.

About 6 percent of children ages 6-11 suffer from untreated tooth decay in their permanent teeth, and higher proportions of low-income, Hispanic, and African American children go without treatment.

Oral health issues can cause other problems. Oral pain causes children to miss school. It was the reason for 2.18 million emergency room visits in 2012 by adults and children. When oral infections are left untreated, they contribute to cardiovascular disease, diabetes, and other health conditions.

With all of this evidence that oral health care is important, it’s no wonder that the United States is taking steps to make oral coverage and care more affordable.

As drafted, the treasury department proposes to make the new rule effective in 2019. Families USA, like our friends at the Children’s Dental Health Project, hopes the rule can go into effect earlier.