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Allows people to enroll in a standalone dental plan on a Health Insurance Exchange without also enrolling in a full qualified health plan. The Secretary is barred from denying enrollment in a standalone dental plan solely because the person is not enrolled in a qualified health plan through the Exchange. This change makes dental-only coverage available through Exchanges, with no new spending or tax changes specified.
Adds a new subsection (f) to Section 1321 of the Patient Protection and Affordable Care Act (42 U.S.C. 18041) to address availability of standalone dental plans.
Prohibits the Secretary from restricting any qualified individual from enrolling in a plan described in section 1311(d)(2)(B)(ii) (a standalone dental plan) offered through an Exchange established under subsection (c) on the basis that the individual is not also enrolled in a qualified health plan offered through the Exchange.
Who is affected and how:
Individuals and consumers: People who want dental coverage but do not want or cannot enroll in a full qualified health plan will gain clearer access to buy standalone dental plans through Exchanges. This particularly helps people seeking only dental benefits, those with lower-cost dental needs, or people with other medical coverage (e.g., employer plans or Medicaid) who want Exchange dental plans separately.
Dental insurers and plan issuers: Standalone dental issuers may see a larger potential customer base and may adjust marketing and product offerings to reach Exchange audiences. They may also need to work with Exchanges on enrollment and premium collection logistics.
Health Insurance Exchanges: Exchanges will need to ensure enrollment systems, eligibility workflows, consumer-facing information, and plan display logic allow dental-only enrollments. These are largely one-time or ongoing administrative tasks and are unlikely to require major legislative funding unless specifically funded elsewhere.
Qualified health plans and marketplaces: The change does not alter qualified health plan benefits or subsidies. It may modestly affect the composition of dental risk pools and uptake but is unlikely to create major disruptions in the medical insurance risk pools.
Overall effect: The provision is a targeted, low-complexity change that expands consumer choice for dental coverage through Exchanges with modest administrative impacts and no direct federal spending or tax changes specified.
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Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
Introduced March 27, 2025 by Margaret Wood Hassan · Last progress March 27, 2025
Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
Introduced in Senate