Obamacare Repealed… what does it mean for dental?


If Republicans repeal Obamacare, how will it affect dental care?

Will Obamacare be repealed? There has been a lot of talk about repealing and replacing Obamacare over the years. Republicans in the House of Representatives have actually passed a bill, but as of this writing the Affordable Care Act is still the law of the land. The bill now heads to the Senate where it has an uncertain fate.

There’s still a long way to go, but it’s more likely than not that Republicans in Congress will eventually coalesce around a strategy for the repeal of some portions of the ACA. Let’s take a closer look at what an Obamacare repeal and replacement might mean for dental care.

The mandates to buy health insurance are removed in the Republican health bill

The individual mandate is probably the most unpopular part of Obamacare. Most people do not want to be forced to purchase health insurance or face a tax penalty. In the American Health Care Act of 2017 that was passed by the House, the individual and employer mandates to buy health insurance have been repealed. Many see this as a good thing, but the net affect is that there will be more uninsured people, even though it may be by their own choice. Employers with more than 50 employees, can also choose to stop offering coverage to employees without any tax penalties.

What about dental? The removal of the individual mandate may have a limited affect on dental care. But the absence of the employer mandate could affect dental plans because if an employer stops offering medical insurance, they would likely not offer other benefits such as dental insurance. This could leave many people without group dental coverage, and they would have to seek individual or family coverage in the open market.

In a Republican healthcare plan, more power will be passed to the states

One of the key components in the American Health Care Act that was passed by the House of Representatives, is a shifting of power from Washington back to the states. With the ACA, most guidelines and regulations regarding healthcare were determined at the federal level and implemented by the Department of Health and Human Services. In the years since the ACA was passed, the Secretary of HHS has become a powerful arbiter of how health insurance is bought and sold across the country. The proposed changes in the House’s health reform bill would allow the states to decide various provisions, though with approval from HHS.

What about dental? The transference of regulatory authority to the states has importance regarding dental care because many provisions that affect dental care will now be decided at the state level. We’ll take a closer look at the most important provisions that could affect dental care.

Essential Health Benefits like pediatric dental could be decided state by state

One of the big components of Obamacare implemented at the federal level by HHS are Essential Health Benefits, which currently include the requirement for pediatric dental. Under the AHCA passed in the House, states would have the ability to apply for a wavier to remove certain requirements in their state including Essential Health Benefits. This means that EHB’s like pediatric dental could be decided on a state by state basis. We could expect that Republican controlled states would possibly remove these requirements, while Democrat led states would likely maintain most Essential Health Benefits.

What about dental? In states that may choose to remove Essential Health Benefit requirements, various benefits could be removed from most medical plans including pediatric dental care. If this were to occur, then many children and families would have to seek other sources for dental care coverage. Though children currently enrolled in the CHIP program would likely not be effected.

Guarantee issue and community rating could be altered in certain states

A few other important provisions of Obamacare that could be decided at the state level is guarantee issue and community rating. Guarantee issue is another way of saying that a member cannot be denied coverage due to a preexisting condition. Community rating states that insurance companies cannot charge sicker members more than healthy members.

If certain states were to decide to weaken guarantee issue or community rating provisions, it could mean that certain people would be denied access to traditional methods of obtaining medical insurance. Although, if states were to remove these provisions they would have to setup a high risk pool for sicker members as an alternative to regular medical insurance.

What about dental? What it boils down to is that some people could see limited access to affordable medical insurance under these changes. This has an effect on dental care as well. If someone is denied for medical insurance it could have negative effects on their dental care because some dental issues have symptoms and necessary treatments that go beyond the scope of regular dental care. Treatments like gum infections, TMJ, certain oral surgeries, and other procedures are often classified as medical treatments and not covered under dental insurance plans. If members only had dental insurance and no medical plan, they would be in a difficult position.

Medical rates could be lowered in some states

In light of some of the negative effects that we’ve discussed, one may ask why would some states decide to make changes to these medical guidelines. The answer is that in some states, the removal of certain Essential Health Benefits, community rating, and limitations on guarantee issue could potentially lower medical premiums for those obtaining health insurance. One of the major complaints of the ACA is the rise of premiums that has become unaffordable for many. Republicans see the removal of various regulations as one way to help reduce the cost of healthcare in order to make it more affordable.

What about dental? The reality is that all families have a limited budget and have to prioritize their spending. When budgeting for insurance as medical costs rise, many will elect medical coverage over dental coverage if forced to make a choice due to overall costs. But if medical costs and premiums begin to decrease, then this makes new funds available for other coverages such as dental insurance. This cost to benefit ratio is true with employee benefit spending at companies, but it can also be true with individuals and families.

A repeal effort could fail and Obamacare would continue as law

Another possibility is that the effort to repeal and replace Obamacare may fail. Republicans struggled to get the House bill approved, and the early stages of discussions in the Senate indicate that it will be a daunting task to get enough votes for passage there too. Plus any bill passed by the Senate will likely make changes to the House bill, which will have to be negotiated in a conference committee. So it’s easy to see the uphill climb that Republicans have in order to pass a new health reform bill, and they just may fall short.

What about dental? If Republicans in Washington do in fact fail to get a bill passed, most of Obamacare will remain in tact. Thus the current market conditions for dental care would likely continue for the foreseeable future.

Time will tell in this long drama that is health care reform. Regardless of the outcome, dental care remains a necessity, and services such as EasyDentalQuotes will continue help individuals and families find access to affordable dental coverage.

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