Monday, July 22, 2019
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Ensuring Lasting Smiles Act will provide health insurance coverage for children born with congenital anomalies or birth defects
WASHINGTON, D.C. – U.S. Senator Tammy Baldwin today announced growing support for her bipartisan reform to ensure health insurance coverage for needed treatment and procedures for individuals born with congenital anomalies or birth defects. After introducing the Ensuring Lasting Smiles Act (ELSA) with Joni Ernst (R-IA), Lisa Murkowski (R-AK) and Sherrod Brown (D-OH), Baldwin’s bipartisan legislation has gained 18 cosponsors.
Senator Baldwin worked on this legislation after hearing the story of 14 year-old Aidan Abbott of Slinger, Wisconsin who was born with Ectodermal Dysplasia (ED), a rare congenital disease, and who has needed intense dental and oral care, and will need reconstructive surgeries throughout his life, among other services related to ED. Despite having comprehensive health insurance, the Abbotts were denied coverage for Aidan’s dental work and forced to pay out of pocket for his treatments. Although most health plans cover care for congenital anomalies, claims are routinely denied or delayed for any oral-related procedures due to an individuals’ disorder.
The Ensuring Lasting Smiles Act (S.560) would close a coverage gap to ensure that health plans cover medically necessary services related to a patient’s anomaly or birth defect, including any serious dental and oral-related procedures that are necessary to maintaining health and overall function. Last week, children and families from across the country came to Capitol Hill as part of the National Foundation for Ectodermal Dysplasia (NFED) Advocacy Day to help garner support for the legislation.
“Aidan’s story continues to inspire my work on this issue to guarantee that individuals born with congenital anomalies have access to the comprehensive health treatments and coverage they need,” said Senator Baldwin. “Despite covering all of his other medical care, his family’s insurance continues to refuse to cover his dental care needs, forcing them to spend thousands of dollars out of their own pockets. That’s why I’m working with my colleagues on both sides of the aisle to pass my bipartisan legislation and close this loophole so families like Aidan’s can get the health care they need at a price they can afford.”
“We are thrilled with the incredible progress our advocates have made in just 5 months since the Ensuring Lasting Smiles Act was introduced in the Senate and House. We have bipartisan support in both houses for this bill which we need so desperately,” said Mary Fete, executive director of NFED. “Thirty-eight families stormed Capitol Hill for NFED Advocacy Day and shared their story about needing insurance benefits to replace and restore their teeth. Many more, advocated at home by calling and emailing their legislators. We continue to be grateful for Senator Baldwin’s leadership. Together, we are confident that we can get ELSA passed for all families with congenital anomalies who need care.”
“Since the re-introduction of the Ensuring Lasting Smiles Act in February of 2019, our families and supporting organizations have been able to garner strong bipartisan support from 180+ co-sponsors in both the House and Senate,” said Aidan’s mom, Becky Abbott of Slinger, Wisconsin. “With the help of Senator Baldwin’s leadership, our families will continue to persistently advocate to move ELSA forward and ensure that all individuals born with congenital anomalies receive the medically necessary treatments they desperately need and deserve.”
The Senate cosponsors for ELSA include Senators Cory Booker (D-NJ), John Boozman (R-AR), Mike Braun (R-IN), Kevin Cramer (R-ND), Deb Fischer (R-NE), Chuck Grassley (R-IA), Amy Klobuchar (D-MN), Ed Markey (D-MA), Jerry Moran (R-KS), David Perdue (R-GA), Gary Peters (D-MI), Jack Reed (D-RI), Jeanne Shaheen (D-NH), Debbie Stabenow (D-MI), Dan Sullivan (R-AK), Sheldon Whitehouse (D-RI) and Roger Wicker (R-MS).
Bipartisan companion legislation in the House is led by Representatives Collin Peterson (D-MN) and Denver Riggleman (R-VA).
The bipartisan legislation is supported by the Academy of General Dentistry, the American Academy of Dermatology Association, the American Academy of Neurology, the American Academy of Oral and Maxillofacial Pathology, the American Academy of Oral and Maxillofacial Radiology, the American Academy of Pediatric Dentistry, the American Association of Oral and Maxillofacial Surgeons, the American Association of Orthodontists, the American Association of Pediatric Plastic Surgeons, the American Association of Women Dentists, the American College of Surgeons, the American Dental Association, the American Society of Craniofacial Surgeons, the American Society of Dental Anesthesiologists, the American Society of Maxillofacial Surgeons, the American Society of Plastic Surgeons, CCD Smiles, Children’s Hospital of Wisconsin, Derma Care Access Network, EveryLife Foundation for Rare Diseases, FACES: The National Craniofacial Association, Foundation for Ichthyosis and Related Skin Types, Inc., Genetic Alliance, International Pemphigus and Pemphigoid Foundation, March of Dimes, National Foundation for Ectodermal Dysplasias, National Organization for Rare Disorders, Pathways for Rare and Orphan Studies, Project Accessible Oral Health, Rare and Undiagnosed Network, SunnyStrong, the APS Type 1 Foundation, the Marfan Foundation, and the Sturge-Weber Foundation. More information is available here.
More information on the Ensuring Lasting Smiles Act is available here.
