What does the Affordable Care Act (ACA) mean for Virginians' oral health?
The new rules require dental insurance coverage for children up to age 19, allow for expanded Medicaid, and make preventive care more affordable.
- State exchanges can include stand-alone dental plans, or medical insurance plans that include dental care. If a stand-alone dental plan is part of the exchange, a medical plan does not have to provide dental care.
- Dental plans in the exchanges cannot charge out-of-pocket expenses for preventive care.
Virginia could use federal funds to expand Medicaid, creating a limited dental benefit for adults. This would:
- Extend insurance plans available through the state exchange for children
- Cover an additional 400,000 adults for emergency dental extractions by increasing Medicaid eligibility
Access for the Underserved
- $11 billion for Federally Qualified Health Centers
- Grants to school and community-based health centers, especially rural areas, where access to care has been limited.
- Increased support for dental programs serving those with limited access to private dental care, including children and special needs patients.
- An educational campaign increasing public awareness about preventing cavities, periodontal disease and oral cancer, focused on the needs of pregnancy, early childhood, special needs patients and the needs of ethnic and minority groups.
- Grants and other funding for studies on preventative treatment.
- School-based sealant programs.
Dental care funding doubled from $15 million to $30 million annually to support:
- Dental training for general, pediatric and public health dentistry.
- Funding for dental students, practicing dentists, dental hygiene education and faculty.
- Alternative dental health care providers (including dental health coordinators).
- A National Health Care Workforce Commission to coordinate among agencies and evaluate training.
All states must now report information for:
- Pregnancy Risk Assessment System (PRAMS): Includes oral health questions that document the status of pregnant women.
- National Health and Nutrition Examination Survey (NHANES): Surveys oral health at the tooth-level.
- Medical Expenditure Panel Survey (MEPS): Tracks dental expenditures and coverage using look-back studies.
- National Oral Health Surveillance System (NOHSS): Requires all states to participate in the CDC's state reports.