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THE SENATE |
S.C.R. NO. |
52 |
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TWENTY-SEVENTH LEGISLATURE, 2013 |
S.D. 1 |
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STATE OF HAWAII |
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SENATE CONCURRENT
RESOLUTION
REQUESTING THE DEPARTMENT OF HEALTH TO ASSESS THE SOCIAL AND FINANCIAL EFFECTS OF REQUIRING HEALTH INSURERS TO PROVIDE COVERAGE FOR MEDICALLY NECESSARY TREATMENT OF OROFACIAL ANOMALIES.
WHEREAS, in Hawaii, the rate of children with orofacial disorders is estimated to be one in every five hundred; and
WHEREAS, the rate of children in Hawaii with orofacial disorders is higher among the Asian, Pacific Islander, and Filipino populations that comprise the majority of the population of the State; and
WHEREAS, the more commonly known orofacial anomalies include cleft lip or cleft palate; and
WHEREAS, three hundred fifty two babies were born with cleft lip and/or cleft palate in Hawaii between 1986 and 2005; and
WHEREAS, orthodontics are the medically necessary treatments needed to proceed with subsequent reconstructive surgeries for these disorders; and
WHEREAS, orthodontics has been a covered medical benefit of the Hawaii Medicaid program for several years, and medically necessary orthodontics are included as an essential health benefit under pediatric oral health in the State's healthcare benefits package; and
WHEREAS, orthodontics are not included as a benefit of commercial health insurance; and
WHEREAS, without appropri1ate orthodontic care, reconstructive surgical outcomes are compromised and result in functional deficiencies in chewing, swallowing, respiration, speech, unstable or malpositioned oral structures, premature tooth loss, and adverse psychosocial effects; and
WHEREAS, these compromised surgical outcomes can create disparities in quality of care, quality of life, and functional outcomes for children with orofacial disorders; and
WHEREAS, California, Colorado, Connecticut, Florida, Indiana, Louisiana, Maryland, Massachusetts, Minnesota, New York, North Carolina, Oregon, South Carolina, Texas, Vermont, Virginia, and Wisconsin have mandated health benefits, including orthodontic care coverage for orofacial and related disorders; and
WHEREAS, mandated health benefits that include orthodontic care coverage for orofacial and related disorders aid in the average lifetime cost of $10,250 for orthodontic care; and
WHEREAS, the Legislature believes that mandatory health insurance coverage for medically necessary treatment of orofacial anomalies will substantially offset the financial hardship on families needing treatment for their children, reduce compromised surgical outcomes, and assist in good health for children born with orofacial abnormalities in Hawaii; now, therefore,
BE IT RESOLVED by the Senate of the Twenty-seventh Legislature of the State of Hawaii, Regular Session of 2013, the House of Representatives concurring, that the Department of Health is requested to conduct an impact assessment on the mandatory health insurance coverage of medically necessary treatment for orofacial anomalies; and
BE IT FURTHER RESOLVED that the Department of Health is requested to submit findings and recommendations to the Legislature, including any necessary implementing legislation, no later than twenty days prior to the convening of the Regular Session of 2014; and
BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to the Director of Health and to the Insurance Commissioner, who, in turn, is requested to transmit copies to each insurer in the State that issues health insurance policies, and to the Children with Special Needs Branch of the Department of Health, State Council on Developmental Disabilities, Lifetime of Smiles Support Group, Kapi‘olani Cleft and Craniofacial Center, Kaiser Cleft Palate Clinic, Tripler Army Medical Center Craniofacial Center, Hawaii Maternal & Child Health Leadership Education in Neurodevelopmental & Related Disabilities Program, Hilopa‘a Family to Family Health Information Center, and American Academy of Pediatrics – Hawaii Chapter.
Auditor; Mandated Coverage; Orofacial Anomalies