Neighbor News
Op-Ed: Toothless Infants Don't Need Mandated Dental Care
Insurance broker discusses healthcare.
As there is a march in America to lower the cost of skyrocketing healthcare premiums, we must take another close look at the Affordable Care Act and explore mandates that are unrealistic and expensive.
Even the most staunch supporters of the law should find fault in the pediatric dental requirement, which requires universal coverage for people under the age of 19. There is no option here; the law is the law.
Under the healthcare reform law, those New Jerseyans covered by such carriers as HorizonBCBSNJ, AmeriHealth, Oscar Benefits and Health Republic NJ are paying additional premiums every month for required pediatric dental coverage. Meanwhile, policyholders covered by Aetna and Oxford have the expense wrapped into the base premium.
In either case, every policyholder is paying more for health care. And the cost is not cheap. For example, Horizon’s “young grins” pediatric dental policy can range from an estimated $360 to $400 a year per child.
What makes this mandate frustrating to my clients is that even newborn infants need to be covered! Imagine the young families that need to find an extra $360 or so a year for pediatric care for a child who has yet to have teeth.
It is stunning that Congress included this provision in the reform law, as we have learned over and over that a “one size fits all” program has never been the right fit for American health care policy.
As a broker with the New Jersey Association of Health Underwriters, I spend plenty of time explaining why the small group market is more expensive than the large group market. Mandates like dental care for infants are just one of the reasons that insurance for groups with 50 people or less has become unaffordable for many small businesses.
We expect this issue to become more paramount in New Jersey in 2016, as the pediatric dental mandate will also become law for insurance groups of up to 100 people. That means that mid-size businesses will soon be asking their employees to share in the burden of pediatric dental – if the employees want the coverage or not.
The debate is no longer if the so-called ObamaCare should be law. What we need to focus on is ways in which to improve the law and make it more applicable to the typical New Jersey business or family that is trying to purchase a health insurance plan that best fits their needs.
We should not buy what we don’t need. If they could talk, I would think that toothless newborns would agree.
Jack Kalosy is a health insurance broker with SASCO Insurance Services, Inc. of Hackettstown
