Affordable Care Act

Obamacare and the dental industry: Part I

April 23, 2014
For most, dentistry is not covered in the Affordable Care Act

Open enrollment for Obamacare on healthcare.gov is officially over for 2014. What does that really mean? Do the new insurance regulations and rules confuse everyone on your staff? What does this new health care initiative mean for patients and the practice you work with?

The new insurance laws are by no means an easy topic to understand and explain. Everyone I’ve encountered seems to be confused on some level. Making matters even more confusing is the fact that every state seems to have its own rules and regulations regarding the new health-care initiative. Add a little political drama into the mix, and you have a perfect cocktail of misinformation and confusion. I’ll keep it neutral and wade through the basics with you here.

In 2010, President Obama signed a federal health care statute that was nicknamed Obamacare. It is also commonly known as the Affordable Care Act (ACA). The goals of the ACA are simple — increase affordability and accessibility to medical insurance, require insurance companies to cover preexisting conditions, and expand public health. This also means that if someone is left uninsured, they could receive a penalty for their 2014 taxes.

So where does dental insurance fall into the new health care reform? Unfortunately, dental coverage is often ignored when discussing the ACA regulations. Long story short, dental insurance is ignored because it isn’t required for adults to have it under the new law. You can find a brief description of the new law regarding dental insurance on Obamacarefacts.com, and on that site there is a link to a Wikipedia page that explains dental insurance.

Uninsured adults can choose an insurance plan that only covers medical needs, leaving an important aspect of a person’s overall health completely out of the picture. Tooth decay is one of the most widespread diseases in the country, yet it was left out of the new law. Any dentist can explain how dental health care plays an important roll in overall health, but our field was somehow glossed over during the reform.

If your state happens to be one of the few that includes dental insurance in its State Health Plans, your office may be experiencing an influx of new patients. State Insurance guidelines have changed with the new law and include a wider range of income requirements. Low-income patients will now have much needed access to dental care. This should be seen as a benefit, not a burden.

Patients who have neglected their teeth can receive treatment and education on forming good dental habits. This could also be a starting point for future generations to form good brushing and flossing habits. This leaves a large portion of private practices and other offices out of the picture in terms of dental care, simply because they chose not to accept state insurance. Of course a few new patients with brand new insurance may roll into your office for a new patient appointment, however, certainly not at the rate that would have been possible if our industry had been included in the new law.

Ashley Pero is a dental assistant who lives in Portland, OR. She has most recently been working for Dental Care Today. She enjoys reading, writing, and learning about new things in dentistry.