•      "This bill would help more families than those affected by the ectodermal dysplasias. It would cover the diagnosis and treatment of a congenital anomaly or birth defect that primarily impacts the appearance or function of the eyes, ears, teeth, mouth, or jaw…Although medical professionals and surgeons are able to correct many of these problems, some insurance companies deny access to care by labeling the procedures as “cosmetic” or “non-functional” in nature…ELSA would address delays and denials in coverage, and ensure that children suffering from birth defects and anomalies get the treatment they need." Source: National Foundation for Ectodermal Dysplasias 

•      "Our members and families are acutely aware of the financial and emotional burden of the numerous medically necessary interventions for people with cleft and craniofacial anomalies. Health plans systematically and routinely deny or delay claims and appeals for treatment of many congenital anomalies by wrongfully categorizing certain treatments or body parts as cosmetic or not medically necessary. This common practice leaves families with the burden of paying 100% of the cost for their child’s medically necessary treatments. And individuals who do not receive timely, continuous care for their congenital anomalies face long-term physical and psychological injuries. ELSA will close loopholes and ensure that group and individual health plans do not deny or delay medically necessary treatments of congenital anomalies, alleviating the financial hardship for people with cleft and craniofacial anomalies and ensuring they have continued support for medical and dental needs beyond childhood." Source: The American Cleft Palate Craniofacial Association

•      "Severe dental anomalies are a frequent feature of many craniofacial conditions and while many private health insurance companies cover preliminary procedures for congenital anomalies, they routinely deny or delay follow-up or corrective procedures – notably, dental-related procedures involving orthodontia and dental implants – deeming them cosmetic or covered by dental plans. Dental insurance coverage is far less comprehensive than medical insurance coverage. As a result, patients and their families are frequently burdened with substantial out-of-pocket expenses for medically necessary reconstructive dental care throughout their lives…This important legislation would close health benefit plan loopholes to ensure all group and individual health plans cover provider-directed medically necessary services as a result of a congenital anomaly impacting the function of the teeth, mouth, jaw, eyes or ears." Source: Multiple American Medical Associations