Covered California backs dental plans for 2014, eyes future changes

Amid criticism from the state insurance commissioner and some children’s advocates, California’s health insurance exchange is moving ahead with a controversial approach to children’s dental coverage for next year while vowing to pursue changes for 2015.

At issue has been whether pediatric dental care should be part of the basic health insurance package sold through the exchange or be sold separately. The exchange, called Covered California, will be offering it on a stand-alone basis to parents next year.

Insurance Commissioner Dave Jones and children’s advocacy groups called on the exchange board to reverse course and ask insurers to include dental benefits in health insurance policies for 2014.

They said this would expand children’s access to dental care and lower costs related to the benefit by spreading the price across a broader pool of people.

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At a meeting Thursday, Covered California officials said that with open enrollment set to begin Oct. 1 there was simply not enough time to rebid contracts for an embedded dental plan and that they didn’t expect any insurers to actually offer it.

Instead, the exchange board said it will pursue the idea for plans sold in 2015.

Meantime, state officials apologized for missteps in how they handled the rollout of children’s dental benefits.

In a staff report, Covered California acknowledged that in April it “incorrectly instructed health plans not to bid embedded plan offerings.... Covered California should have welcomed bids of embedded, bundled or stand-alone offerings.”

Peter Lee, the exchange’s executive director, said “we have all been moving very rapidly the last six months. We fell down on the job” in terms of soliciting feedback and debate among the exchange board and the general public.

Children’s dental coverage is one of 10 “essential health benefits” under the federal Affordable Care Act, yet this coverage is optional to buy. California officials said they will consider making it mandatory as part of the discussion about plans for 2015.

In June, Covered California selected six companies to offer pediatric dental coverage through the exchange.

In this dental debate, one concern for state officials was maintaining uniform benefits across health insurers so that consumers can easily comparison-shop.

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