Few pieces of legislation to pass Congress and be signed into law by the president have prompted as much continuing study and debate as to the Affordable Care Act (ACA) of 2010. Most of its important provisions take hold in 2014, so it’s time to take a look at how dentistry will be affected.
While lawmakers did little that will change the relationship between adults and their dentists, they did include oral healthcare among the minimum coverage requirements that will be available to people under 21 years old.
Starting in 2014 as part of the mandate, individuals and groups must get the insurance that includes pediatric dental care. This will also be included when individuals get health insurance through the “exchanges” that will soon be set up. As many as three million children who are currently not covered will receive dental benefits. This may put an additional burden on dental offices. Dentists are looking to see what kind of payments they can expect to receive for work done through the healthcare exchange agreements.
Flexible Spending Accounts
With Flexible Spending Accounts (FSA), workers can set aside pretax wages each year for medical and dental expenses. Up until 2013, employers can decide how much employees can put into these accounts each year.
Starting in 2013, the ACA will limit the amount of money that can be tucked away into FSAs each year at $2500. This figure will be adjusted for inflation each subsequent year. Employers will have the ability to limit this figure even more. It’s also important to note that the $2500 limit applies to employees no matter how many dependents they may have. A single person and someone supporting a family of four both have to make meet their needs with the same $2500 ceiling.
As parents who have kids in the middle of orthodontic treatment plans know, it’s easy to spend more than $2500 a year in out-of-pocket dental expenses. FSAs can be used to pay for orthodontic treatment, so limiting this figure could force some patients to pay using after-tax income.
The ACA includes grants for as many as 15 “demonstration programs” to train or employ what are called “alternative dental healthcare providers.” Just as nurse practitioners are increasingly being used to treat more common ailments, dental therapists or dental hygienists might be seeing more patients on their own. Congress wants to use these new providers to improve dental care options in areas where it is more difficult to come by. You might find yourself seeing one of these providers rather than a fully trained dentist in some instances.
Similarly, the bill includes grants to fund dental clinics and oral care departments in regular health clinics. Also, if you have kids, you might not have to take them to the dentist to get their teeth sealed; grants are being awarded to bring this service to schools.
A Close Call
One provision that would have affected many dental patients was pulled from the ACA bill at the last minute. It was set to include a five percent tax on cosmetic dental procedures. That got yanked from the legislation, and Congress made up for the lost money by adding a ten percent tax on tanning salons.
So, if you can’t afford the ten percent tanning salon tax, you’ll be able to show off some pasty, white skin in addition to those pearly whites.