The ACS supports the Ensuring Lasting Smiles Act (ELSA). This legislation would address issues that prevent access to necessary diagnosis and treatment for patients with congenial craniofacial anomalies such as such as cleft lip and palate, skeletal and maxillofacial abnormalities, facial paralysis, microtia, hypodontia, and craniosynostosis.
Many private health insurance companies cover the preliminary procedures related to these conditions but routinely deny or delay follow-up or corrective procedures, claiming that they are cosmetic in nature. ELSA would require all private group and individual health plans to cover medically necessary services that repair or restore a patient’s anomaly. The U.S. House of Representatives passed ELSA on April 4, 2022, by a vote of 310 to 110. ACS will continue to advocate for final passage.
The Children’s Health Insurance Program (CHIP) provides vital low-cost health coverage to low-income children, and in some states, pregnant women, who do not qualify for Medicaid. The ACS supports efforts to ensure sustainable funding for CHIP and provide continuous eligibility for CHIP beneficiaries. Under existing law, Congress must regularly reauthorize CHIP funding, which is currently set to expire in 2027. This creates an ongoing cycle of uncertainty for beneficiaries, health care providers, and states. The ACS supports eliminating this financial uncertainty by passing permanent funding for CHIP.
In addition to funding uncertainty, the cycle of enrollment and disenrollment, called “eligibility churn,” means that beneficiaries may lose their CHIP coverage despite being eligible. This is caused by inefficient paperwork and other reporting requirements or temporary income fluctuations. The ACS supports a continuous eligibility policy that will require states to provide 12 months of continuous enrollment for children in Medicaid and CHIP.