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Five things you need to know about the Affordable Care Act and dentistry

Posted by Goldin Peiser & Peiser on May 30, 2014 12:27:29 PM

June 2014

By: Erick Cutler

When the Affordable Care Act (ACA), commonly known as “Obamacare,” was signed into law, thousands of questions cropped up as to how the sweeping reforms to the health insurance industry would impact physicians of all types. There has been much discussion in the media about the impact on patients and doctors, but there is little talk of how dentists will be impacted.

Whatever your position on the controversial law, it’s important to be aware of how the changes impact your dental practice. Make sure you keep in mind these five key elements about the ACA:

  1. The Affordable Care Act does not require insurance providers to cover dental care for adults.

As of January 1, 2014, the ACA requires that insurance policies cover dental care for children, but not for adults. According to the American Dental Association, pediatric oral care benefits are considered “essential health benefits” and must be covered by all insurance policies, whether they’re purchased through the insurance exchanges or not. By 2018, it is estimated that 8.7 million children could have access to preventative dental care.

  1. The Affordable Care Act does not require individuals to purchase dental insurance.

Even though the ACA made the purchase of health insurance compulsory, dental insurance was largely ignored in the bill. Dental care is not an essential health benefit for adults, according to the law, and insurers are not required to provide coverage for dental work in their policies. Critics of the law suggest that the Affordable Care Act should have mandated that people purchase dental insurance, especially in the face of declining numbers of adults who have dental coverage.

  1. The Affordable Care Act increases the number of patients who are eligible for dental services.

In the Affordable Care Act’s expansion of the federal Medicaid program and the addition of children’s dental benefits to all policies, millions of new patients will be seeking private dental care. The American Dental Association estimates these changes will add 11 million pediatric dental visits and 2.9 million adult visits to dental practices across the country.

  1. The Affordable Care Act may accelerate the shift away from dentist-owned practices to corporate dentistry.

Dentistry has been heading away from dentist-owned practices for years, as more dentists seek a lighter workload and more economic stability. This unfortunately decreases the salary potential for dentists and may limit competition, especially in underserved areas. As incomes for dentists decline and dental insurance becomes more expensive, it may become difficult to attract bright young adults to the field.

  1. The Affordable Care Act included a new excise tax on medical device purchases.

In one of the more controversial provisions of the law, the Affordable Care Act made necessary medical devices slightly more expensive. At the start of 2014, the IRS began collection of the medical device excise tax, which is levied at 2.3 percent of the price of all medical devices. As it pertains to the dentist, the tax is not imposed on items that can be purchased in the dental office, such as toothbrushes, floss, etc. However, other items such as radiology systems and handheld mirrors are not exempt. While the dentist is not taxed directly, the cost will ultimately be passed on from the manufacturers to the consumer—in other words—your patient.

The ACA, like all other laws, has its pros and cons, and states are still fighting with the Obama Administration over the law in court. The full impact of the ACA on dental practices and other healthcare professionals remains to be seen, but it’s important for dentists to be keenly aware of how the law will affect their businesses.

Our Dental Practice Leader Erick Cutler can also provide you with infromation about the Act. You can contact him at 214-635-2541 or ECutler@GPPcpa.com. To learn more about Erick, you can visit his bio or Google+ page.

Note: This content is accurate as of the date published above and is subject to change. Please seek professional advice before acting on any matter contained in this article.

Topics: Dental