Running head: HEALTH CARE POLICY PAPER

Health Care Policy Paper

Vera Nixon
Bon Secours Memorial School of Nursing
Business of Healthcare in Complex Systems
NUR 4240
Ms. Mazzoccoli & Ms. Mikelaites
July 3, 2016
Honor Code, I pledge
Health Care Policy Paper
The purpose of this paper is to discuss a chosen health care law and its implications
related to the profession of nursing, patients, financial obligations, and opportunities and/or
challenges that the law may incur. The law chosen is a proposed law submitted by House
Representative Morgan H. Griffith in relation to dental coverage for children (H.R. 3463, 2015).
Health Care Law
The proposed law, named the Aligning Childrens Dental Coverage Act was introduced
to the House of Representatives in September of 2015 (H.R. 3463, 2015). As this bill is related
to health care, it was then referred to the appropriate committee and then subcommittee, being

the Subcommittee on Health within the committee of House Energy and Commerce (H.R.
3463, 2015). The purpose of this bill is to attempt to reduce limitations on health insurance plans
that do not offer pediatric dental benefits in order to allow for pediatric dental insurance to be
available in an area where other insurance companies offer such coverage (H.R. 3463, 2015). If
passed, this law would be considered to be in effect at the same time as the Patient Protection and
Affordable Care Act (ACA) (H.R. 3463, 2015). At this time, under the ACA, it has been made
available for any child under the age of eighteen, but is not a requirement to purchase (U.S.
Centers for Medicare & Medicaid Services, n.d.)
Impact on Nursing Profession and Patients
For the patients, and their families, the inclusion of pediatric dental coverage is a big step,
as many insurance options are still lagging in relation to adult dental coverage. While pediatric
nurses are not primarily concerned with dental health, when assessing patients, dental health can
be indicative of many aspects of a pediatric patient, including but not limited to poor hygiene,
poor diet, illness, and access to healthcare services (Blevins, 2011). In addition, almost half of
children from 2 years to 11 years of age, 42%, have had tooth decay history, with cavities being
more common in childhood than asthma or hay fever, up to 7 times more common (Blevins,
2011). Furthermore, almost a quarter of those children with cavities, remain untreated (Blevins,
2011).
Nursing needs to be aware of the formation of poor oral hygiene and cavities in every age
range of the pediatric patient. While the American Nurses Association (ANA) doesnt have an
official standing on the pediatric dental care, they are supportive of preventative care (American
Nurses Association [ANA], 2013) which is the mainstay of pediatric dentistry, to follow up and
teach oral health as a preventative measure for cavities and abscesses.

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Financial Implications

As it stands, in response to the overwhelming amount of children that develop poor

dental health, with cavities and abscesses, an overwhelming number of hours are missed from
school, at least 50 million hours, in relation to pain and or treatment for that poor dental health
(Blevins, 2011). As a result of the need for pediatric oral health, the financial implications of this
proposal must be taken into effect. As preventative care is the shift of focus for healthcare
currently, pediatric patients should have well-child visits with their dentist at least once a year,
if not every six months. As a result of the proposal, through the ACA, around 8.7 million
children could gain access to dental coverage by 2018 (Essling & Litch, 2013). Overall, the
businesses providing health insurance will be hit the hardest, with requirements of at least
providing an option for pediatric dental coverage (Essling & Litch, 2013). At this time, the
option for pediatric dental coverage is mandated, but it still remains the adults choice whether or
not to participate (U.S. Centers for Medicare & Medicaid Services, n.d.), as a result,
reimbursement should not be an issue as the choice still remains in the hands of the caregivers.
Opportunities and Challenges
Challenges that may arise from this proposal, is that dental coverage in general is
confusing, as it is sometimes included in health insurance, and other times is an added insurance
package, as well as not always offered through a company for employees. The offer for pediatric
dental coverage is even more confusing, as it could also be a second addition, as dental may be
added for the adults first. Another challenge that may arise is the lack of transparency related to
the different dental plans available, and what they need for their children (Essling & Litch,
2013). A third challenge that may arise is related to an influx of previously untreated patients
into the dental system (Essling & Litch, 2013), which could put a strain on the current system in

HEALTH CARE POLICY PAPER

place, as well as an increase of out-of-pocket costs for both the families and the insurance
companies. With a history of untreated oral health issues, the first year of treatment may end up
costing families more than they even anticipated.
Opportunities for healthcare providers cold include such items as reinforcement of a
healthy diet by dentists as well as other healthcare providers, overall reinforcement of education
related to oral hygiene, and provision to specialists that may be able to provide more consistent
care related to oral and dental health, than urgent care sites or emergency rooms.
Conclusion
In conclusion, the proposal of providing more opportunities for individuals and families
to participate in pediatric dental health coverage has the potential to boost the overall oral and
dental health of children. With provisions for dental health insurance, the possibility for
reductions in admissions to the hospital, with or without surgery, reductions in dental surgeries,
reductions in emergency room visits, and a positive change for oral health habits can occur
(Blevins, 2011). The costs for emergency room visits, urgent care visits, and surgical suites can
be reduced through preventative oral health care. While initial costs may increase for both the
family and the insurance provider in the beginning, with an influx of previously untreated
patients (Essling & Litch, 2013), in the long run financial gain is to be made, as well as positive
health outcomes.

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References

Aligning Childrens Dental Coverage Act, H.R. 3463, 114th Cong. (2015).
American Nurses Association. (2013). HHS: Covered preventive services. Retrieved from
http://www.nursingworld.org/MainMenuCategories/HealthcareandPolicyIssues/IssueBriefs/ANA-Comments/Preventive-Serivces-.aspx
Blevins, J. Y. (2011). Oral health care for hospitalized children. Pediatric Nursing, 37(5), 229235. Retrieved from http://www.medscape.com/viewarticle/752508_9
Essling, M., & Litch, C. S. (2013). Behind the code: How will the affordable care act affect
pediatric dental practices? Pediatric Dentistry Today, 26-28. Retrieved from
http://www.aapd.org/assets/1/7/How_Will_the_ACA_Affect_Pediatric_Dental_Practices
_PDT_NOV_2013.pdf
U.S. Centers for Medicare & Medicaid Services. (n.d.). Health benefits and coverage: Dental
coverage in the marketplace. Retrieved July 3, 2016, from
https://www.healthcare.gov/coverage/dental-coverage/