How the Affordable Care Act Impacts Vision and Dental Plans

My Comments: We’re still waiting to hear what the Supreme Court is going to say about the constitutionality of the Patient Protection and Affordable Care Act. Personally, I don’t have a problem with the mandate and while I have reservations about some of the provisions in the Act, I have problems with a lot of what comes out of Washington. All of it either gets into the system and we get used to it or it gets tweaked and we get used to it and get on with our lives.

Here’s an article that deals with one of the small elements of the Act that will favorably impact 100 million Americans and perhaps 2 million small business owners. And if you believe Mitt Romney, he’s going to repeal the whole Act as soon as he takes office as our next President. Again, we hold ourselves out as the most wonderful place to live our lives on the face of the planet, yet time and again, measured against other countries, we fall way done the list in terms of health outcomes and the price we pay to get there. Vision and dental issues are just as much a part of the quality of life matrix as is blood pressure and obesity.

January 12, 2012 ( as it appeared on http://www.benefitspro.com )

There’s some really good news for benefits selling professionals amidst the tumult of healthcare reform: you are more needed than ever to help your customers navigate a benefits landscape that’s been rapidly and inexorably changing since President Barack Obama signed the Patient Protection and Affordable Care Act on March 23, 2010. That much, at least, has become clear as employers, plan providers, healthcare providers, policymakers and benefits sellers all try to grasp the ultimate impact of the Affordable Care Act on supplemental benefits — particularly vision and dental benefits — as the ACA’s provisions are gradually implemented through 2018.

Vision and dental plans make only a brief cameo appearance in the 906-page ACA. But that brief mention and the subsequent regulations coming out of HHS have profound ramifications for all children currently lacking dental or vision coverage — as well as for more than 100 million Americans and upwards of two million small employers whose benefits include vision, dental, or both.

The ACA mandates the creation of healthcare exchanges whose participating plans must offer “pediatric services including oral and vision care” as part of an Essential Health Benefits Package (EHBP) intended to set the baseline for healthcare coverage. A surprising amount hinges on the inclusion of those fateful words in the ACA — and on how expansively the U.S. Department of Health and Human Services (and eventually state legislators and regulators) interprets their meaning as it develops, vets, and ultimately promulgates regulations that determine the actual benefits considered to be essential.

To delve deeply into these implications, this past fall Benefits Selling Magazine convened an expert roundtable comprised of key leaders within the vision and dental plan markets. As the two leading supplemental benefits, vision and dental plans share comparable cost structures, utilization patterns, and business models, and are often marketed and sold side-by-side. So it’s not so surprising that these two separate but similar industries have been galvanized into concerted action to ensure that remarkable popularity, cost-effectiveness, and outcomes of vision and dental benefits are encompassed (rather than rolled over) by the juggernaut of healthcare reform.