The Dental Gap in the Affordable Care Act

The Affordable Care Act (ACA) mandates that insurers cover dental care for children. Children’s dental care is one of the ten essential health benefits that set the bar for health insurance.   But children’s dental care is separate from other essential benefits on the exchanges. Dental plans are sold separately from medical insurance and children’s dental coverage is optional.  People shopping on the federal and state exchanges are not required to purchase dental insurance, and they won’t receive financial support for it.  Experts are now warning that this flaw in the program may leave children without dental coverage.


Tooth decay is the most common disease of childhood.  Of children ages 6 – 19, fourteen percent have cavities that have not been treated. This can cause pain and might lead to severe infections.  The percentage of uninsured children who visited the dentist at least once per year was 25% in 2011 – down from 31% in 2003.  If children’s dental insurance were mandatory on the insurance exchanges, 3 million children would have coverage by 2018.  Data for this blog post was supplied from an article in the New York Times on December 17, 2013.

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