Axne Sponsors Bipartisan Bill to Ensure Coverage for Children Born with Birth Defects

WASHINGTON – U.S. Congresswoman Cindy Axne (IA-03), Collin Peterson (D-MN) and a bipartisan group of members reintroduced the Ensuring Lasting Smiles Act, legislation to ensure health care coverage for Iowa children suffering from rare genetic disorders and birth defects. The bipartisan legislation would close a coverage gap by requiring insurance companies and health plans cover serious dental and oral procedures needed to treat congenital anomalies, or birth defects. U.S. Senator Joni Ernst is an original co-sponsor of the Senate companion version which was reintroduced this week.   

Congresswoman Axne joined this effort after she heard from two moms from Dallas County, Jennifer Steele and Sarah Ward. Their children, Alli Steele and Amelia and Lucas Ward, suffer from ectodermal dysplasias, a rare genetic disorder where children can’t develop teeth or sweat glands. The moms discussed the serious physical and mental issues associated with missing and mis-shaped teeth, including chewing, swallowing, digestive, speech and self-esteem issues. While the Steele and Ward families have health care, they are forced to pay thousands of dollars of out-of-pocket costs because insurance companies refuse to cover medically necessary services.

Many insurance companies deny access to care by labeling the procedures as “cosmetic.” Denial or delay of these reconstructive procedures could lead to long-term physical and psychological injuries. The Ensuring Lasting Smiles Act would close a loophole that has allowed private insurance companies and health plans to deny coverage for medically necessary procedures to treat congenital abnormalities.

“There’s nothing ‘cosmetic’ about ensuring children suffering from genetic disorders can chew, swallow and speak,” said Rep. Axne. “Parents should never have to choose between paying for necessary medical treatments for their children or putting food on the table. I’m proud to join Senator Ernst in this bipartisan effort to ensure every child in Iowa gets the care they desperately need at an affordable price.”

“The Ensuring Lasting Smiles Act will close a loophole that has previously allowed insurance companies to deny claims for the medically necessary treatments for our children and families,” said Jennifer Steele from Dallas County. “We are grateful that Congresswomen Cindy Axne listened to Alli’s story and has taken action, to ensure families with ectodermal dysplasias and congenital anomalies get the coverage they desperately need.”

Specifically, the Ensuring Lasting Smiles Act would:

• Ensure that all health plans cover medically necessary services, including reconstructive surgeries and oral-related procedures, as a result of congenital anomalies or birth defects;
• Stipulate that such coverage include services and procedures that functionally repair or restore any missing or abnormal body part that is medically necessary to achieve normal body functioning or appearance, and clarifies that this includes adjunctive dental, orthodontic or prosthodontic support; and
• Exclude cosmetic procedures or surgery.

Congresswoman Axne is committed to expanding access to quality, affordable health care for all Iowans. Earlier this month, Congresswoman Axne signed onto a bipartisan effort to protect the Medicare Advantage program to ensure Iowa seniors have access to comprehensive, affordable health care as they age.

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