American Society of Plastic Surgeons Works with Congress to Secure Passage of the Ensuring Lasting Smiles Act

ARLINGTON HEIGHTS, IL – The American Society of Plastic Surgeons (ASPS) is leading the charge to educate members of Congress on the importance of the Ensuring Lasting Smiles Act, which would require all group and individual health plans to cover medically necessary services related to a patient's anomaly or birth defect, including reconstructive surgeries and oral-related procedures.

U.S. Senators Tammy Baldwin (D-WI) and Joni Ernst (R-IA) introduced the Ensuring Lasting Smiles Act on February 26, while Representatives Collin Peterson (D-MN-07) and Denver Riggleman (R-VA- 05) have also introduced a companion bill in the House of Representatives.

"I've heard stories from patients who have been denied coverage for serious oral procedures related to congenital anomalies, forcing them to pay thousands of dollars out of their own pockets. Those stories inspired my work on this issue to guarantee that individuals born with congenital anomalies have access to the comprehensive health treatments and the full coverage they need and deserve," said Senator Baldwin. "My bipartisan legislation will close this coverage gap and make sure patients and families can get the health care they need at a price they can afford."

Although most health plans provide coverage for congenital anomalies, many consistently deny or delay claims for reconstructive and dental procedures. The bipartisan legislation would address coverage denials and delays that could lead to long-term physical and psychological injuries. The bill would also require that such coverage includes services that functionally repair or restore any missing or abnormal body part that is medically necessary to achieve normal body functioning or appearance, such as adjunctive dental, orthodontic or prosthodontic support.

According to the Centers for Disease Control and Prevention, one in 33 babies in the U.S. is born with a congenital anomaly. Many born with congenital anomalies suffer from severe oral and facial defects such as cleft lip or palate, skeletal and maxillofacial anomalies, hypodontia and enamel hypoplasia. Plastic surgeons play an integral role in treating these conditions, performing 24,428 reconstructive procedures to treat congenital anomalies in 2017, according to the 2017 National Plastic Surgery Statistics.

"The Society has been working with Congress to improve access to necessary reconstructive surgical care for years," said ASPS president, Alan Matarasso, MD. "We are very thankful for the efforts of Senators Baldwin and Ernst and Representatives Peterson and Riggleman as this bill can changes lives by providing children with the medical care they need and deserve."

Seventy-five ASPS surgeons from 24 states advocated for this bill during the ASPS Advocacy Summit in Washington, D.C. in June 2018 and met with their members of Congress to provide insight on how it will impact patients. The Society also coordinated an extensive letter writing campaign to 76 key members of Congress encouraging them to support the bill in the 115th Congress.

This summer ASPS will lead a delegation of plastic surgeons to Capitol Hill in an effort to further educate members of Congress about the bill. Additionally, the Society will work with key health care and patient advocacy groups to raise public awareness about the issue. ASPS plans to carry out these advocacy efforts to help ensure passage of the bill in the 116th Congress.