NEAR-UNIVERSAL DENTAL COVERAGE FOR CHILDREN OFFERS REASONS TO SMILE

- Health care reform legislation defines pediatric dental services as an essential benefit -

• 31 Designated Dental Health Professional Shortage Areas in New Jersey

• 40 Designated Dental Health Professional Shortage Areas in Connecticut

PARSIPPANY, NJ (June 16, 2010)

The potential result of two new pieces of legislation – near universal oral health care for the nation’s children – offers Americans good reason to smile during National Smile Month this June.

According to Walter VanBrunt, president and CEO of Delta Dental of New Jersey, which also administers self-funded dental benefits programs in Connecticut, the combination of the passage of the Children’s Health Insurance Program Reauthorization Act (CHIPRA) in 2009 and the more recent Patient Protection and Affordable Care Act have the potential to bring oral health coverage to nearly all of the nation’s children. 

The policy changes come a decade after the Surgeon General’s Report on Oral Health in America first sounded the alarm about a silent epidemic of dental and oral diseases in America. Even now, millions of children continue to suffer with unmet dental needs. “Dental cavities are five times more common than asthma and seven times more common than hay fever,” notes VanBrunt. “Despite increased dental insurance coverage, increased access to fluoridated water and advances in prevention methods, tooth decay remains the most common chronic disease affecting children.”

Now, CHIPRA mandates comprehensive dental coverage for children in separate state Children’s Health Insurance Programs (CHIP), and allows states to use CHIP funds to provide dental coverage to CHIP-eligible children who have medical coverage but lack sufficient dental coverage.

CHIPRA also allows federally qualified community health centers (FQHC) to contract with private practice dentists to provide oral health services. 

“This is significant, since there are 49 million Americans living in more than 4,000 designated Dental Health Professional Shortage Areas where many safety-net clinics operate,” says VanBrunt of Delta Dental. There are 31ⁱ designated Dental Health Professional Shortage Areas in New Jersey and 40ⁱⁱ in Connecticut. “CHIPRA also provides for education to new parents on important oral health practices during a child’s early years. Both dental and medical professionals recommend that a child go to the dentist by age one or within six months after the first tooth erupts, but most American children don’t see their family dentist until they are well over two years old.” 

The Patient Protection and Affordable Care Act and its corresponding reconciliation bill will fill remaining coverage holes and greatly expand oral health treatment and education initiatives.

Health care reform legislation defines pediatric dental services as an essential benefit, meaning that once health insurance exchanges are up and running in the year 2014, small group and individual insurance plans offered through the exchanges – and new small group and individual plans offered outside the exchanges – must include pediatric dental coverage. The combination of this new coverage mandate, existing Medicaid, CHIP and CHIPRA programs and those who are already privately insured will mean near universal access to dental coverage for children. 

The legislation provides funding to study and demonstrate the effectiveness of research-based dental caries (tooth decay) disease management. Findings from these studies could lead to widespread adoption of proven practices that will prevent unnecessary pain, suffering and other complications resulting from tooth decay.

“These and other reforms present a real opportunity to advance oral health in America to a level that may not have seemed possible a decade ago,” VanBrunt says. “Today, 10 years after the Surgeon General’s seminal report, millions of children are being spared the fate of insurance concerns that prevent them from making an appearance at the dentist’s office. And, that should give us all a reason to smile.”

About Delta Dental
Delta Dental of New Jersey Inc. is New Jersey’s leading dental benefits company, providing or administering coverage to more than one million people through contracts with employers in New Jersey and Connecticut. The Delta Dental system offers seamless dental benefits administration for employer groups throughout the country and has the largest network of dentists in the nation. For more information, visit www.deltadentalnj.com.

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