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Health Insurance: Mandatory Coverage for Craniofacial Birth Defects

This act mandates that health insurance plans cover the diagnosis and treatment of craniofacial, oral, or maxillofacial congenital anomalies. This means individuals with these conditions will have access to necessary procedures, including dental and orthodontic support, aimed at improving function or appearance, without fear of denial by their insurer.
Key points
Health insurers must cover diagnosis and treatment for craniofacial, oral, or maxillofacial birth defects.
Coverage includes medically necessary items and services to improve function or restore normal appearance, including dental, orthodontic, and prosthodontic support.
Cost-sharing and coverage limits for these treatments cannot be more restrictive than for other medical benefits.
The act specifically excludes cosmetic surgery performed solely to improve appearance or self-esteem, unrelated to a birth defect.
Health plans will be required to provide clear information to enrollees about these new coverage terms.
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Additional Information
Print number: 117_HR_7702
Sponsor: Rep. Dunn, Neal P. [R-FL-2]
Process start date: 2022-05-10
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Summarized by: gemini-2.5-flash-preview-05-20
Source data: api.congress.gov
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OFFICIAL LEGAL TITLE

Ensuring Lasting Smiles Act

FREQUENTLY ASKED QUESTIONS

What is the official ID of this bill?

The official print number for this legislation is 117_HR_7702.

Which chamber initiated this legislation?

This legislation was initiated in the House of Representatives.

When did the legislative process begin?

The process officially started on 2022-05-10.

What are the main provisions?

Key points include:

  • Health insurers must cover diagnosis and treatment for craniofacial, oral, or maxillofacial birth defects.
  • Coverage includes medically necessary items and services to improve function or restore normal appearance, including dental, orthodontic, and prosthodontic support.
  • Cost-sharing and coverage limits for these treatments cannot be more restrictive than for other medical benefits.
  • The act specifically excludes cosmetic surgery performed solely to improve appearance or self-esteem, unrelated to a birth defect.
  • Health plans will be required to provide clear information to enrollees about these new coverage terms.
What is the specific legal status?

The current status is Expired.

Where can I read the full text of this legislation?

The full official text is available at: View full text

Who is the primary sponsor?

The primary sponsor is Rep. Dunn, Neal P. [R-FL-2].

What is the latest detailed status?

The latest detailed status is: Referred to the Subcommittee on Health.

Is this summary verified?

Yes. This content was analyzed by AI and verified by the Lustra Judge System on 2025-12-28.

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Health Family