H.R. 9833: Ensuring Kids Have Access to Medically Necessary Dental Care Act

This bill would change parts of the Children’s Health Insurance Program (CHIP) so that children covered by CHIP, and in some cases pregnant women covered through CHIP, would have stronger dental coverage rules.

What it would do

• Ban annual and lifetime dollar limits on CHIP dental benefits. States would no longer be allowed to cap how much dental care CHIP will pay for each year or over a person’s lifetime for covered dental services.
• Apply this to targeted low-income children. The new rule would cover dental services for children enrolled in a state CHIP plan for targeted low-income kids.
• Also cover some pregnant women. If a state uses CHIP to provide pregnancy-related assistance, the same no-limit rule would also apply to dental services for targeted low-income pregnant women covered under that option.
• Require “wraparound” dental coverage in certain cases. The bill would turn an existing CHIP dental coverage option into a requirement in some circumstances. In practice, this means states would have to offer dental-only supplemental coverage to help fill gaps when a child’s main dental coverage is not enough.
• Make states offer the supplemental dental coverage rather than just allowing it. The bill changes the language from “may” to “shall,” which means the state would be required to provide this extra dental coverage instead of merely being permitted to do so.

Timing

The changes would take effect 6 months after the bill becomes law.

Relevant Companies

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