Obamacare and pediatric dental insurance
What is the penalty?
For 2015 it’s 1/12 of 2% of household income every month you are not compliant, thus 2% a year. There is a minimum fee but nearly all dentists will make enough that they will be hit with the 2%. The government takes the higher of 2% or the fee. 2016 it will be 2.5%
Not within exchanges run by the federal government. A federal agency interpretation of the ACA has determined that within the exchange, the dental EHB need only be offered. However, in the individual and small group markets outside the exchange, the dental EHB must be purchased. The ADA strongly disagrees with this interpretation, but at this time it appears that all exchanges run by the federal government will be operating within these parameters. On the other hand, states have the authority to mandate the purchase of the dental EHB. Few states have chosen to mandate purchase or are considering doing so.
http://practicemanagement.dentalproductsreport.com/affordable-care-act-what-you-need-know-about-how-it-will-affect-pediatric-dental-patients Article by Kevin Henry no longer able to access.
For example, while the ACA requires every state to offer children’s dental services, the package of services can vary. In Illinois, the exchange will offer orthodontia but it is likely that this benefit would be strictly controlled. The U.S. Department of Health and Human Services (HHS) has ruled that children’s dental insurance is “a mandated offering but not a mandated purchase” but states can set their own rules.
Pediatric dental benefits are a mandated offer but optional purchase on the Marketplace, but are a mandated offer and mandated purchase outside of the Marketplace. Pediatric dental plans will not have an annual or lifetime benefit maximum for covered services. There will be an out-of-pocket limit of $700 per child and $1,400 per family. As a dental provider, you will most likely not know the difference between dental plans purchased on the Marketplace versus outside the Marketplace. Adult dental benefits are not covered in the ACA. ISDS
Passing of ACA impact
ACA has not had an impact on reducing the number of emergency room visit for dental infections. Rampa 2019 JOE
Based on the data the ACA has not decreased the number of emergency room visits overall either. In fact they have actually increased slightly. The percentages that they have increased in the years since ACA are higher than the percentage population growth. In it’s goal of reducing expensive emergency room visits, the ACA is a total failure.