Biden’s Election-Year Play to Further Expand Obamacare

The Biden administration wants to make dental care more accessible to Americans. But don’t try to make an appointment just yet.

new rule Out this month Allows states to make adult dental care a benefit that health insurance companies must cover under the Affordable Care Act.The following ACA enrollment hits record high this yearthe proposal represents an election-year desire for the future of Obamacare: It doesn’t require states to do anything, even if it’s to show off President BidenDesigned to make the ACA a stronger safety net.

“This is huge, very important,” said Colin RuschPolicy Director community catalyst, a health insurance advocacy group. He said the Biden administration's new rules are the “first real change” to underwriting provisions since the law was passed in 2010.

But like many things in health care, expanding access to dental services is more complicated than it sounds.

estimate 68.5 million Nonprofit says U.S. adults will lack dental insurance by 2023 CareQuest Oral Health Institute.This is better than 2.5 times Roughly 26 million Americans of all ages People who lack health insurance.

Millions of Americans lost dental coverage last year as part of Medicaid “relaxation,” which reduced the number of low-income people covered by the program during the pandemic.

at the same time, Untreated dental disease expected to take toll on U.S. more than $45 billion According to statistics, productivity is lost every year Centers for Disease Control and Preventionwhich has been linked to a long list of more serious health problems, including heart disease and diabetes.

Still, efforts to expand dental coverage in the United States have long failed due to falling costs. When people have dental insurance, they tend to use it. Therefore, including coverage in a health insurance policy can increase overall premiums.

This is one of the reasons traditional Medicare specifically excludes most dental care. (Many private Medicare Advantage plans offer some dental coverage to entice seniors to enroll.)

Working to Add Dental Benefits to Medicare deprived Biden's “Build Back Better” legislation was passed in 2022 as the Inflation Reduction Act.On the contrary, the executive branch Clarified and expanded limited cases Where medical insurance can pay for dental care. Any progress on oral health — including giving states the option to require adult coverage — is viewed as a win by advocates. Children's dental insurance has become a basic benefit under the ACA.

But whether they actually get coverage depends on whether states explicitly add dental benefits to benchmark plans in the ACA insurance marketplaces. These plans not only determine what services Affordable Care Act insurance must cover, but also set the parameters for health plans for state employees and many private employers.

Reusch said some states are considering making changes, but it will be some time before anything is confirmed. States must decide by May 2025 whether to include dental care in baseline ACA plans; the benefit will not take effect until the 2027 plan year.

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