In the United States, health plans systematically and routinely deny claims and appeals for medically-necessary procedures related to congenital abnormalities or birth defects. This practice leaves individuals and families with the burden of how to pay for their or their child’s treatment or procedures that are required to repair function — and to help them enjoy happier, healthier lives.

About 4 percent of children born in the U.S. have congenital abnormalities or birth defects that affect the way they develop, function, or look, often for the rest of their lives.

The bipartisan Ensuring Lasting Smiles Act (ELSA) has been re-introduced in the 119th Congress to address these coverage denials and ensure that individuals suffering from birth defects and anomalies get the treatment they need. While ELSA passed in the U.S. House in 2022, it did not make it to the floor in the U.S. Senate.

The legislation would:

  • Require a group health plan and a health insurance issuer offering group or individual health insurance coverage, to provide coverage for outpatient and inpatient items and services related to 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.
  • Ensuring access to the medically necessary items and services necessary to functionally improve, repair, or restore bodily function or approximate a normal appearance due to a congenital anomaly, that primarily impacts the appearance or function of the eyes, ears, teeth, mouth, or jaw, such as cleft lip and palate, maxillofacial abnormalities, microtia, hypodontia, and congenital aphakia. Including any medically necessary item or service to achieve normal body functioning, and it clarifies that coverage includes adjunctive dental, orthodontic, and prosthodontic support.
  • Explicitly excludes coverage of cosmetic surgeries.

Will you join us in supporting ELSA?

How You Can Help

Together, we can improve the quality of life for all individuals affected by these disorders and congenital anomalies. Organizations that become official supporters of the Ensuring Lasting Smiles Act help show our legislators that this life-changing issue requires urgent attention. By joining us, you’ll add your voice to a message that Americans care about fair and just medical treatment for children and individuals affected by birth defects.

ADVOCACY RESOURCES: Check out our Advocacy Resources page for helpful information and resources to help you share your story and advocate to your federal legislators.

For our efforts to be successful, we need supporters like you who will reach out to policymakers about ELSA. It’s equally powerful to ask your organization’s constituents and advocates to contact their legislators, too.

For questions about supporting ELSA, please contact Becky M. Abbott, Co-chair NFED Family Advocacy Committee at becky@nfed.org.

Become an Advocacy Sponsor

We’re already seeing incredible support from the American Association of Oral and Maxillofacial Surgeons, American Dental Association and American Society of Plastic Surgeons.

American Association of Oral and Maxillofacial Surgeons
American Dental Association
American Society of Plastic Surgeons

These organizations have garnered support from legislators and held Hill Days to raise awareness for ELSA, effectively bringing professional and patient voices to the need for this legislation.

Show Your Support

Join the National Foundation for Ectodermal Dysplasias and the organizations listed below in helping families affected by all congenital anomalies by becoming an ELSA supporter. Or, sponsor our advocacy efforts with a financial gift.

We are proud to be supporting the Ensuring Lasting Smiles Act along side the following organizations:

Become a Supporter of ELSA

When you sign-on to support the Ensuring Lasting Smiles Act (ELSA), your organization agrees to officially support and advocate for the bill. We’ll add your organization’s name to our growing list of supporters and include it whenever we reference the groups supporting this legislation. On occasion, NFED will also send email updates to share the latest ELSA news and progress.

For questions about supporting ELSA, please contact Becky M. Abbott, Co-chair NFED Family Advocacy Committee at becky@nfed.org.

  • Your Contact Information

  • Organization Information

  • This field is for validation purposes and should be left unchanged.