What This Bill Does
This bill changes the Children's Health Insurance Program (a government health insurance program for kids with low to moderate incomes) to ban limits on dental coverage. It requires states to offer additional dental-only coverage for certain children who need it.
Who It Affects
Targeted low-income children covered by state child health plans. Targeted low-income pregnant women if a state chooses to provide them pregnancy-related assistance. State governments that run the Children's Health Insurance Program.
Key Provisions
• States cannot set lifetime limits (total dollar amounts a person can receive over their whole life) or annual limits (total dollar amounts a person can receive in one year) on dental benefits for eligible children and pregnant women (Sec. 2).
• States must offer dental-only supplemental coverage (additional coverage that adds to what a person already has) under the program following specific requirements (Sec. 3).
• The dental benefits that states provide cannot have lifetime or annual limits even if the coverage is similar to a benchmark dental package (a standard dental coverage model) (Sec. 2).
What Changes
States can no longer impose lifetime or annual dollar limits on dental services for children and certain pregnant women in the Children's Health Insurance Program. States are required, not permitted, to offer dental-only supplemental coverage following the requirements in the law.
Important Definitions
Targeted low-income child: Not explicitly defined in bill text. Benchmark dental package: Not explicitly defined in bill text.
Effective Date
Both changes take effect 6 months after this bill becomes law.
I
118TH CONGRESS
1ST SESSION
H. R. 590
To amend title XXI of the Social Security Act to prohibit lifetime or annual
limits on dental coverage under the Children’s Health Insurance Pro-
gram, and to require wraparound coverage of dental services for certain
children under such program.
IN THE HOUSE OF REPRESENTATIVES
JANUARY 27, 2023
Ms. BARRAGA´N (for herself, Mr. COHEN, Mr. CA´RDENAS, and Mr. BISHOP of
Georgia) introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce
A BILL
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 chil-
dren under such program.
Be it enacted by the Senate and House of Representa-
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tives of the United States of America in Congress assembled,
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SECTION 1. SHORT TITLE.
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This Act may be cited as the ‘‘Ensuring Kids Have
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Access to Medically Necessary Dental Care Act’’.
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•HR 590 IH
SEC. 2. PROHIBITION OF LIFETIME OR ANNUAL LIMITS ON
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DENTAL BENEFITS UNDER THE CHILDREN’S
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HEALTH INSURANCE PROGRAM.
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(a) IN GENERAL.—Section 2103(c)(6) of the Social
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Security Act (42 U.S.C. 1397cc(c)(6)) is amended—
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(1) in subparagraph (A), by inserting ‘‘, subject
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to subparagraph (D),’’ after ‘‘shall include’’;
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(2) in subparagraph (B), by striking ‘‘A State’’
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and inserting ‘‘Subject to subparagraph (D), a
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State’’; and
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(3) by adding at the end the following new sub-
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paragraph:
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‘‘(D) NO LIFETIME OR ANNUAL LIMITS ON
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DENTAL BENEFITS.—A State shall not establish
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lifetime or annual limits on the dollar value of
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benefits for dental services provided under the
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State child health plan to a targeted low-income
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child, and, in the case that the State elects to
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provide pregnancy-related assistance pursuant
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to section 2112, to a targeted low-income preg-
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nant woman (as defined in section 2112(d)), in-
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cluding benefits for such services that are pro-
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vided through dental coverage that is otherwise
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equivalent to a benchmark dental package de-
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scribed in subparagraph (C).’’.
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•HR 590 IH
(b) EFFECTIVE DATE.—The amendments made by
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this section shall take effect on the date that is 6 months
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after the date of enactment of this Act.
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SEC. 3. REQUIRING WRAPAROUND COVERAGE OF DENTAL
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SERVICES FOR CERTAIN CHILDREN UNDER
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CHIP.
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(a) IN GENERAL.—Section 2110(b)(5) of the Social
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Security Act (42 U.S.C. 1397jj(b)(5)) is amended—
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(1) in the paragraph header, by striking ‘‘OP-
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TION’’ and inserting ‘‘REQUIREMENT’’;
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(2) in subparagraph (A), by striking ‘‘may
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waive’’ and inserting ‘‘shall waive’’; and
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(3) in subparagraph (C)—
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(A) in the subparagraph header, by strik-
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ing ‘‘CONDITIONS’’ and inserting ‘‘REQUIRE-
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MENTS’’; and
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(B) by striking ‘‘may not offer dental-only
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supplemental coverage under this paragraph
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unless the State satisfies the following condi-
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tions’’ and inserting ‘‘shall offer dental-only
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supplemental coverage under this paragraph in
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accordance with the following requirements’’.
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•HR 590 IH
(b) EFFECTIVE DATE.—The amendments made by
1
this section shall take effect on the date that is 6 months
2
after the date of enactment of this Act.
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Æ
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