Ensuring Lasting Smiles Act

Floor Speech

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Mr. PALLONE. Madam Speaker, I thank Chairwoman Eshoo for yielding.

Madam Speaker, I rise in strong support of H.R. 1916, the Ensuring Lasting Smiles Act, a bipartisan bill that will help patients with congenital anomalies and birth defects get the necessary treatment that they deserve.

Three percent of American children are born with congenital anomalies or birth defects that affect the way they look, develop, or function, often for the rest of their lives. These children require serious medical treatment. But for far too long, insurance companies have been unfairly denying treatment, despite an official medical diagnosis, by deeming it cosmetic or because the treatment involves dental services. This is unacceptable. This treatment is critically important and medically necessary, particularly for children with serious dental anomalies.

During our legislative hearing on this bill in committee, we heard from Kevin Koser about his family's longstanding struggles to get his son Kannon's medical treatment covered. Kannon was diagnosed with ectodermal dysplasia when he was 1 year old, and this had a drastic impact on his health and quality of life. Ectodermal dysplasia is a congenital anomaly that affects the development of the hair, skin, teeth, and other body parts. Kannon sprouted his first tooth at the age of 4, and this has severely restricted his diet and impacted his ability to speak.

In accordance with the treatment plan established by his doctor, his family began pursuing dentures for Kannon; however, their family health plan denied the medically necessary treatment for Kannon and deemed it as not a covered benefit. The Koser family is not alone.

Madam Speaker, there are countless children across the country whose medically necessary treatments are unfairly denied by insurance companies. These children may have to forego the care they need to live healthy and fulfilling lives because their families simply cannot afford the treatment. Too often, their families are stuck with the financial burden of paying out of pocket for medically necessary treatment despite having health insurance, and children like Kannon are forced to delay necessary care that is meant to restore bodily function.

The National Foundation for Ectodermal Dysplasias estimates that some families will pay upwards of $150,000 out of pocket in their lifetime for medically necessary treatments. This is for medical care that should be rightfully covered by insurance.

The Ensuring Lasting Smiles Act will require all individual and group market health plans to cover medically necessary treatment resulting from congenital anomalies and ensure that children like Kannon get the treatment they need. This is important, commonsense legislation that has--as Ms. Eshoo said--310 bipartisan cosponsors. I commend Ms. Eshoo for her leadership on this legislation as the prime sponsor of the bill.

This important bill will improve the health and well-being of countless Americans and ensure that individuals born with congenital anomalies have the opportunity to live a healthy life. Children like Kannon and his family should have the peace of mind to know that medically necessary treatment will be covered.

Madam Speaker, I urge all of my colleagues to support this bill.

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