ADEA Washington Update

Oral Health Not Required Under HHS Proposed Rule

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On Feb. 23, the Departments of Health and Human Services, Labor, and Treasury released a proposal to extend the availability of short-term health insurance plans. The new rule would extend the maximum duration of short-term plans-which are not required to cover all of the Affordable Care Act’s (ACA) essential health benefits (EHBs)-from just under three months to 364 days. The proposed changes stem from the Oct. 12, 2017 executive order issued by President Trump that provided for HHS to make regulatory changes to health insurance plans.

Individuals between jobs, those who find ACA plans too expensive or people whose providers are out-of-network under ACA plans could potentially benefit from these newly extended short-term plans, according to an HHS fact sheet. According to Centers for Medicare & Medicaid Services Administrator Seema Verma, “allowing short-term, limited-duration insurance to cover longer periods gives Americans options and could be the difference between someone getting coverage or going without coverage.”

The Department of Labor has already proposed its companion regulation to widen access to a form of coverage known as association health plans. The proposed rule would reclassify such plans so that they no longer have to include the 10 EHBs—which include pediatric oral health and mental health services. The proposed rule does include measures to help consumers who purchase short-term, limited-duration policies understand the coverage they are getting. The proposal would require one of two versions of a notice to appear in the contract and in any application materials that the plan is not required to comply with ACA provisions.

ADEA is monitoring these proposals and working with our coalition partners to ensure that oral health coverage remains a part of health care coverage.

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