PPACA Overlooks Adult Dental Coverage


The American Dental Association and related groups have cried foul on PPACA for requiring inclusion of pediatric dental benefits as a defined Essential Health Benefits but ignoring adult dental care altogether. Critics of this move claim that it is inconsistent, confusing and overall a missed opportunity for PPACA to include dental care for all Americans as an element necessary to overall good health. Indeed, studies have shown that proper dental care can assist with the identification of emerging chronic medical conditions such as diabetes and heart disease.

Years ago, it was not uncommon to have medical and dental insurance in one bundled package for employees to purchase. As healthcare expenses began to rise dramatically, employers started offering them separately as a way to manage costs. Since the law was enacted, employers have been struggling with the additional costs of PPACA and are forced to reexamine medical benefit offerings. Employees may have to forgo dental insurance because of additional premium or out of pocket expenses on the medical plan. Critics anticipate the omission of adult dental coverage in PPACA will result in an overall devaluing of dental benefits, and possibly seeing it more commonly on the list of voluntary benefit offerings, meaning that employees that elect dental will pay the full premium for it. The overarching result is a likely decline in dental insurance enrollment which will only make dental expenses higher for more invasive procedures in the future.

Some employers will continue to value dental insurance and will offer it as it is in synch with health engagement initiatives. Employers that are smaller, or struggling, may feel differently, like dental insurance is a luxury that people can purchase at full cost if they really want it.

The truth is that including dental care for adults would simply increase PPACA’s budget, adding to the expense of an already unaffordable law. Plus, dental ailments are not generally seen as life or death but more an option to cover unforeseen expenses like a root canal or a crown. There is some speculation that the law will be amended to include adult dental coverage in the future, but for now it’s looking like an oversight.