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Proposed Federal Rule on Health Benefit Packages Fails to Address Critical Oral Health Issues, American Dental Association Tells HHS

December 21, 2012

Contact Information:
Rob Raible: Telephone: 202.789.5166 Email:
Richard Green: Telephone: 202.789.5170 Email:

A proposed federal rule affecting implementation of the Affordable Care Act’s provisions establishing health benefit plans within the insurance exchanges does not address a number of critical oral health issues, said the American Dental Association.

The rule, "Patient Protection and Affordable Care Act; Standards Related to Essential Health Benefits, Actuarial Value, and Accreditation," sets forth the Department of Health and Human Services’ guidelines for the states as they move forward in implementing their health insurance exchanges and developing the benefit plans those exchanges will offer to individuals and small businesses.

In official comments filed this week with HHS, the ADA identified four main goals that it believes the agency should stress with state officials:

  • The federal and state officials involved in establishing exchanges must ensure that consumers know the full value of what they will be paying for.
  • Stand-alone dental plans and medical plans with dental benefits must be able to compete on an equal footing both inside and outside the exchanges to ensure consumers have an wide selection of dental plans.
  • The pediatric dental essential health benefit should be a required purchase for all families with children who buy their coverage in the individual or small group market.
  • Children up to age 21 should be covered by a dental benefit and there should be adult dental coverage for emergencies as part of state essential health benefit packages.

About the ADA

The not-for-profit ADA is the nation's largest dental association, representing 163,000 dentist members. The premier source of oral health information, the ADA has advocated for the public's health and promoted the art and science of dentistry since 1859. The ADA's state-of-the-art research facilities develop and test dental products and materials that have advanced the practice of dentistry and made the patient experience more positive. The ADA Seal of Acceptance long has been a valuable and respected guide to consumer dental care products. The monthly The Journal of the American Dental Association (JADA) is the ADA's flagship publication and the best-read scientific journal in dentistry. For more information about the ADA, visit For more information on oral health, including prevention, care and treatment of dental disease, visit the ADA's consumer website