Dentistry and Health CareAs of March 2021, the Affordable Care Act (ACA), or Obamacare, is still active. However, one of its major initial clauses requiring individuals to have healthcare, was abolished at the federal level in 2019.

What is the Affordable Care Act?

The Affordable Care Act (ACA) was initiated by President Barack Obama in 2010. Originally, the ACA required every US resident to purchase a healthcare plan, and those without an insurance plan were subject to a tax penalty. Anyone unable to afford healthcare was offered assistance by the federal government.

In 2019, President Trump reduced the tax penalty for not having health insurance to $0, so individuals without a health insurance plan will not receive a fine in most states.

The Future of the Affordable Care Act

Since 2018, a lawsuit claiming the ACA is unconstitutional has been circulating in various courts. After the tax penalty was reduced to $0, some legislators claimed it is unconstitutional to still require individuals maintain health coverage. 

The Supreme Court agreed to take the case in 2020, and oral arguments were heard in November 2020. A ruling from the Supreme Court is expected in the spring or early summer of 2021.

Why does it matter?

Many patients are able to afford dental care because of the Affordable Care Act through Medicaid expansion.

Medicaid is the single largest source of health coverage in the United States. It is a joint program on both the federal and state level that provides health coverage for over 72.5 million people in the US. There are certain groups of individuals mandated by the federal government that states must cover. However, states also have the option to cover additional groups of people. This is called expanding Medicaid coverage.

The ACA created the opportunity for states to expand Medicaid to cover children, nearly all low-income US citizens under age 65, and adults with income at or below 133% of the federal poverty line.

The ACA included features specifically affecting oral health:

  • Required every state’s Medicaid to include pediatric coverage
  • Required health care exchanges to offer pediatric dental benefits
  • Expanded dependent coverage has been shown to improve affordability of dental care for young adults.


ASDA Policies

ASDA’s E-12 policy encourages all U.S. CODA-accredited dental schools to accept Medicaid at their respective clinics. 

ASDA’s H-5 policy supports providing dental services to all patients, regardless of reimbursement method.
 

What has ASDA done?

  • On March 28, 2019, more than 400 ASDA members lobbied for specific principles to be included in health care reform legislation. Attendees encouraged lawmakers to preserve certain Medicaid benefits that would assure oral health services for children and allow states to preserve adult dental benefits under Medicaid if they choose.
  • On April 17, 2020, ASDA, along with over 50 other dental organizations signed on to a letter requesting that the Department of Health and Human Services and Centers for Medicare and Medicaid Services provide immediate access to capital by releasing funding from the CARES Act Provider Relief Fund to dentists that are Medicaid providers.

Resources

Sources

https://www.medicaid.gov/medicaid/eligibility/index.html