Ensuring Lasting Smiles Act

HR 3277, the Ensuring Lasting Smiles Act, requires group health plans and health insurance issuers to cover medically necessary outpatient and inpatient treatments for congenital anomalies or birth defects primarily affecting the eyes, ears, teeth, mouth, or jaw. This includes reconstructive procedures, dental/orthodontic support during treatment, and follow-up care, but excludes purely cosmetic surgery not tied to a medical diagnosis. Cost-sharing (like copays) for these services must not be stricter than for other medical benefits. The law takes effect for plan years beginning January 1, 2026, and mandates insurers to provide notice about this coverage to beneficiaries.