How Josh Hawley can keep many Missouri families from insurance nightmares | Opinion

Few moments are more frightening for parents than hearing their child needs surgery. For families whose children are born with congenital anomalies such as cleft lip, cleft palate or other medically significant facial differences, that fear is often compounded by another reality: battling insurance companies for medically necessary care.

Congress has an opportunity to make that fight less common by passing ELSA, the Ensuring Lasting Smiles Act. As a member of the influential Health, Education, Labor and Pensions committee, Sen. Josh Hawley should support its passage — not only because it reflects Missouri’s values of protecting children and strengthening families, but because it would help ensure that patients receive the care their physicians determine is medically necessary.

Children born with congenital anomalies frequently require treatment over many years. Reconstructive surgeries, dental procedures, orthodontic care and related therapies are often part of a carefully coordinated treatment plan that extends into adolescence or even early adulthood. Yet families can face insurance denials for treatments that specialists consider medically necessary simply because they fall outside narrow coverage definitions or arbitrary age limits.

The Ensuring Lasting Smiles Act seeks to address those gaps by requiring many group health plans and insurers to cover medically necessary treatment related to congenital anomalies and birth defects that primarily impact the function or appearance of the eyes, ears, teeth, mouth or jaw, including reconstructive procedures and associated dental care when appropriate. The goal is straightforward: Allow patients to complete medically necessary treatment without unnecessary financial or administrative barriers.

For Missouri families, that could mean fewer difficult choices between financial stability and their child’s health. Rural families, in particular, often travel long distances to reach specialized care. Adding repeated insurance appeals and unexpected out-of-pocket costs only increases the burden. Reducing those obstacles allows parents to focus on what matters most — their child’s recovery and long-term well-being.

Supporting ELSA would also be consistent with principles that have long resonated across Missouri. Strong families deserve support. Children with medical needs should have access to appropriate care. Health insurance should function as a safety net when families need it most, especially for conditions present at birth that are beyond anyone’s control.

This issue is not fundamentally about politics. It is about ensuring that a child born with a congenital condition can receive the full course of medically necessary treatment recommended by qualified healthcare professionals.

Whether a child lives in Kansas City, St. Louis, Springfield, Columbia or any of the hundreds of rural communities around Missouri, families deserve confidence that medically necessary care will not be interrupted because of insurance coverage gaps.

Sen. Hawley has often spoken about advocating for working families and standing up for children. Supporting the Ensuring Lasting Smiles Act would provide an opportunity to advance those priorities through legislation that addresses a practical problem affecting families across Missouri and the nation.

Missouri has a proud tradition of rallying around neighbors in times of need. Passing the Ensuring Lasting Smiles Act would reflect that tradition by helping children receive medically necessary care, reducing uncertainty for parents and allowing families to focus on healing rather than insurance disputes.

Missouri families should not have to spend years fighting for treatments that medical experts have already determined are necessary. Sen. Hawley can help change that by supporting passage of the Ensuring Lasting Smiles Act and helping ensure that every Missouri child has the opportunity to receive the care they need to live healthy, confident lives.

Aaron Bumann is a pediatric dentist practicing in the Kansas City area. He is the public policy advocate for the Missouri Academy of Pediatric Dentistry, dedicated to optimal oral health for all Missouri children.