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New ACA Policy Expands Access To Dental Care. Now, States Need To Act

The Biden administration's recent rule allows states to include adult dental services as essential health benefits (EHBs) in most health plans under the Affordable Care Act (ACA), marking a significant step towards improving access to oral health care. This decision addresses the fragmented state of oral health care within the broader health care system and aims to reduce health disparities, improve health outcomes, and open access to oral health care for millions of people. Click here for article.

  • Prior to this rule, routine adult oral health services were not included as EHBs under the ACA, limiting access to dental coverage for many adults.

  • The new rule removes the prohibition on states including adult dental services as EHBs, providing states with the flexibility to improve access to dental care.

  • States that add adult dental as an EHB will also ensure coverage for people qualifying for Medicaid through the ACA's Medicaid expansion or state Basic Health Program.

  • While this rule is a positive step, it does not mandate routine adult dental services as EHBs at the federal level, and states must voluntarily decide to include them.

  • Federal policymakers should continue to address oral health coverage gaps in other health insurance programs, such as Medicare and Medicaid, to ensure comprehensive coverage for all.

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