Representative Neal Dunn (R-FL) is spearheading a bipartisan, bicameral bill that would ease treatment coverage for anomalous congenital disabilities.
Specifically, the Ensuring Lasting Smiles Act (ELSA) requires all health insurance plans for individuals or groups to cover medical necessities for congenital disabilities affecting eyes, ears, teeth, mouths, or jaws.
Moreover, the coverage and services must improve or restore these affected areas and cannot be used for purely cosmetic treatments or surgeries.
"Many families with children who are born with congenital anomalies face significant financial barriers to accessing the treatment their child needs. This treatment is not just cosmetic. These conditions can have long-term health consequences that can severely impact everyday life," said Rep. Dunn in his press release, adding, "This bipartisan and bicameral legislation will help alleviate the financial hardship that many families endure to get their children the vital care they need. I'm proud to lead this important initiative and would like to thank my colleagues for helping us put a smile on every child's face."
Representative Kim Schrier (D-WA), the bill's cosponsor in the House, said, "For far too long, countless patients, including children, have been unable to access treatment for congenital anomalies such as ectodermal dysplasias and cleft lip and palate because their health insurance refused to cover care, leaving them either without treatment or burdened with thousands of dollars in medical expenses."
"This bill would tackle this issue head-on by requiring private health insurance plans to cover medically necessary services for treating congenital anomalies and birth defects, thus allowing patients with these conditions to secure and afford the treatment they need," Rep. Schrier continued.
Senators Tammy Baldwin (D-WI) and Joni Ernst (R-IA) are introducing the Senate companion bill.
"For millions of Americans, medically necessary care for birth defects can cost thousands of dollars out of pocket, or for others, it is entirely out of reach because of the cost – despite having health insurance," said Sen. Baldwin, adding, "I'm proud to work with Democrats and Republicans to put this care in reach so more Americans can lead healthy lives, and more families can focus on caring for their loved ones, not figuring out how they will afford medically necessary care."
Finally, Sen. Ernst said, "To support young Iowans like Alli Steele, who was born with Ectodermal Dysplasia, this bipartisan legislation will help Iowa families by ensuring that health plans cover medically necessary services related to patients' congenital anomalies of the eyes, ears, teeth, mouth, or jaw."
