H.R. 1916 would amend the Public Health Service Act, the Employee Retirement and Income Security Act, and the Internal Revenue Code to require group and nongroup health insurance plans to provide coverage for the diagnosis and treatment of congenital anomalies. Under the bill, required coverage would be expanded to include medical services that are necessary to improve, repair, or restore any body part to achieve normal function or appearance. The bill stipulates that coverage limits and cost-sharing requirements could be no more restrictive than those applied to a plan’s other medical and surgical benefits.
On March 25, 2022, CBO transmitted a cost estimate for H.R. 1916, the Ensuring Lasting Smiles Act, as introduced in the House of Representatives on March 16, 2021. This estimate reflects a change to the effective date from January 1, 2022, to January 1, 2024.
