Last updated on: 7/31/2013 | Author: ProCon.org

Does Obamacare Require Dental Coverage for Adults? – NO

General Reference (not clearly pro or con)

Health Care.gov, a federal government website managed by the US Centers for Medicare & Medicaid Services, stated the following on its webpage, “Can I Get Dental Coverage in the Marketplace?” (accessed July 31, 2013):

“Under the health care law, dental insurance is treated differently for adults and children 18 and under.

Dental coverage for children is an essential health benefit. This means it must be available to you either as part of a health plan or as a free-standing plan. This is not the case for adults. Insurers don’t have to offer adult dental coverage…

In the Marketplace, dental coverage will be included in some health plans. You’ll be able to see which plans include dental coverage when you compare them. You’ll also see what the dental benefits are. If a health plan includes dental coverage, you will pay one premium for everything. The premium shown for the plan includes both health and dental coverage…

In some cases separate, stand-alone plans will be offered.”

PRO (yes)

Pro

[Editor’s Note: Based upon a neutral reading of the Patient Protection and Affordable Care Act and bi-partisan third party analysis, this question seems to have a clear and obvious Con (no) answer, and ProCon.org has therefore presented the responses in a single column with no opposing perspective.]

CON (no)

Con

The Los Angeles Times stated the following in its July 15, 2013 editorial, “An Obamacare Insurance Exchange Gap,” available at latimes.com:

“The 2010 Patient Protection and Affordable Care Act, better known as Obamacare, requires health insurance policies to cover 10 ‘essential health benefits,’ such as hospital stays, outpatient treatments and maternity care. Those essential benefits also include pediatric — but not adult — dental and vision care.”

Con

J. Thomas Russell, DDS, general dentist, on Mar. 5, 2011 wrote in his article “Obamcare Omits Dental Care,” on the Sound Dentistry website:

“The Regulations determine how the program will be administered, are still being created — but they only deal with children’s dentistry. If you are an adult, to use the President’s favorite phrase: ‘You’re on your Own.’

The Reform of the US Health Care System, when it is fully implemented, will require everyone to purchase a Medical Insurance Policy. This feature is the so-called Individual Mandate that will insure the medical needs of everyone.

However there is no individual Mandate for DENTAL CARE, only a provision for children’s dental care after 2014.”

Con

The National Association of Dental Plans stated the following in a Sep. 2011 whitepaper abstract, “Offering Dental in Health Exchanges: A Roadmap for State and Federal Policymakers,” available at nadp.org:

“The ACA [Affordable Care Act] expressly allows the offering of standalone dental plans — both child only and adult policies — in Exchanges. This reflects the current dental plan market, wherein a vast majority of Americans access dental coverage under a policy that is separate from their medical coverage. While adult dental coverage may be purchased, the premium and cost sharing subsidies included as part of the ACA will only be applied to the purchase of benefits necessary to meet the ‘pediatric oral services’ requirement of EHBP [Essential Health Benefits Package] in the American Health Benefits Exchange. Adults eligible for subsidies for their medical coverage who wish to purchase dental coverage must pay for the full cost of their dental policies.”