Ensuring Kids Have Access to Medically Necessary Dental Care Act
Bill: H.R.1792 | Sponsor: Rep. Barragan, Nanette Diaz (D-CA)
Policy area: Health

Summary:
Ensuring Kids Have Access to Medically Necessary Dental Care Act
This bill modifies dental coverage under the Children's Health Insurance Program (CHIP). Specifically, the bill prohibits lifetime or annual limits on CHIP dental coverage. It also requires states to offer dental-only supplemental coverage under CHIP to children who have other health insurance but are otherwise eligible for CHIP (i.e., wraparound coverage); such coverage is currently at the option of the state.

To amend title XXI of the Social Security Act to prohibit lifetime or 
annual limits on dental coverage under the Children's Health Insurance 
  Program, and to require wraparound coverage of dental services for 
                  certain children under such program.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Ensuring Kids Have Access to 
Medically Necessary Dental Care Act''.

SEC. 2. PROHIBITION OF LIFETIME OR ANNUAL LIMITS ON DENTAL BENEFITS 
              UNDER THE CHILDREN'S HEALTH INSURANCE PROGRAM.

    (a) In General.--Section 2103(c)(6) of the Social Security Act (42 
U.S.C. 1397cc(c)(6)) is amended--
            (1) in subparagraph (A), by inserting ``, subject to 
        subparagraph (D),'' after ``shall include'';
            (2) in subparagraph (B), by striking ``A State'' and 
        inserting ``Subject to subparagraph (D), a State''; and
            (3) by adding at the end the following new subparagraph:
                    ``(D) No lifetime or annual limits on dental 
                benefits.--A State shall not establish lifetime or 
                annual limits on the dollar value of benefits for 
                dental services provided under the State child health 
                plan to a targeted low-income child, and, in the case 
                that the State elects to provide pregnancy-related 
                assistance pursuant to section 2112, to a targeted low-
                income pregnant woman (as defined in section 2112(d)), 
                including benefits for such services that are provided 
                through dental coverage that is otherwise equivalent to 
                a benchmark dental package described in subparagraph 
                (C).''.
    (b) Effective Date.--The amendments made by this section shall take 
effect on the date that is 6 months after the date of enactment of this 
Act.

SEC. 3. REQUIRING WRAPAROUND COVERAGE OF DENTAL SERVICES FOR CERTAIN 
              CHILDREN UNDER CHIP.

    (a) In General.--Section 2110(b)(5) of the Social Security Act (42 
U.S.C. 1397jj(b)(5)) is amended--
            (1) in the paragraph header, by striking ``Option'' and 
        inserting ``Requirement'';
            (2) in subparagraph (A), by striking ``may waive'' and 
        inserting ``shall waive''; and
            (3) in subparagraph (C)--
                    (A) in the subparagraph header, by striking 
                ``Conditions'' and inserting ``Requirements''; and
                    (B) by striking ``may not offer dental-only 
                supplemental coverage under this paragraph unless the 
                State satisfies the following conditions'' and 
                inserting ``shall offer dental-only supplemental 
                coverage under this paragraph in accordance with the 
                following requirements''.
    (b) Effective Date.--The amendments made by this section shall take 
effect on the date that is 6 months after the date of enactment of this 
Act.
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