Promising Legislation

Ensuring Lasting Smiles Act (ELSA)

The Ensuring Lasting Smiles Act (ELSA) introduced on 3-16-2021 is a bipartisan, bicameral bill led by Senate sponsors Senator Tammy Baldwin (D-WI) and Senator Joni Ernst (R-IA) and House sponsors Congresswoman Anna Eshoo (D-CA-18) and Congressman Drew Ferguson (R-GA-3).

ELSA would require health plans and insurers to provide coverage for outpatient and inpatient items and services related to the diagnosis and treatment of a congenital anomaly or birth defect, including any medically necessary procedure or service to achieve normal functioning.

Currently, most insurance companies auto-deny claims for medical treatment when the missing body part is teeth. Importantly, ELSA closes a coverage gap to ensure that health plans cover medically necessary services related to a patient’s anomaly or birth defect, including any serious dental and oral-related procedures that are necessary to maintaining health and overall function.

Current Status: After introduction in the Senate, the bill was passed by the 117th Congress. Congress subsequently determined that the bill required modifications, and a reintroduced bill was referred to the Subcommittee on Health, where it remained and has yet to be reintroduced in the 118th Congress which runs from January 3, 2023, through January 3, 2025.