As the world’s largest Congenital Diaphragmatic Hernia charity and an organization that mentors and advocates for like congenital anomalies, CDH International fully supports the US House of Representatives legislation, H.R. 7702: Ensuring Lasting Smiles Act
CDH International joins the American Academy of Pediatrics, American College of Surgeons, March of Dimes, NORD, Smile Train, Genetic Alliance, EveryLife Foundation for Rare Diseases, The Marfan Foundation, and many other prestigious medical nonprofits to band together in support of this legislation for patients.
In the United States, health plans systematically and routinely deny claims and appeals for medically-necessary procedures related to congenital abnormalities or birth defects. This practice leaves families the burden of how to pay for their child’s treatment or procedures that are required to repair function — and to help kids enjoy happier, healthier childhoods.
About 4 percent of children born in the U.S. have congenital abnormalities or birth defects that affect the way they develop, function, or look, often for the rest of their lives.
Sen. Tammy Baldwin (D-WI) and Sen. Joni Ernst (R-IA), along with Representatives Collin Peterson (D-MN) and David Young (R-IA) introduced the bipartisan Ensuring Last Smiles Act (ELSA) in 2018 to address these coverage denials and ensure that children suffering from birth defects and anomalies get the treatment they need.
The legislation would:
- Ensure that all group and individual health plans cover medically necessary services, including needed dental procedures, as a result of congenital abnormalities,
- Stipulate that such coverage include services and procedures that functionally repair or restore any missing or abnormal body part that is medically necessary to achieve normal body functioning or appearance, and clarifies that this includes adjunctive dental, orthodontic or prosthodontic support; and
- Exclude cosmetic procedures or surgery
