What is ELSA?

The goal of ELSA is to provide health insurance benefits for outpatient and inpatient treatment related to any congenital or craniofacial anomaly. This bill ensures that any procedure related to restoring function or appearance due to a birth defect would be covered by insurance from birth until function is restored. Of note, ELSA has strong bipartisan support in both houses of Congress with over 25 cosponsors in the Senate and 132 in the House. Over 30 patient advocacy and health care professional organizations have also supported this legislation.

The work on this legislation originated from Senator Tammy Baldwin’s (D-WI) interaction with a family with a child who was born with Ectodermal Dysplasia. Despite having comprehensive health insurance, the family was denied coverage for extensive dental work and was forced to pay out of pocket.

Why is ELSA important?

Many of 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.

ELSA works to close loopholes that allow insurance companies to deny medically and dentally necessary treatment and services for patients with various conditions. ELSA would alleviate the financial hardship for people with cleft and craniofacial anomalies and ensure they have continued support for medical and dental needs beyond childhood. While speech intervention is not specifically named in this bill, ACPA believes it could be included within several provisions of ELSA.

Importantly, ELSA includes dental, orthodontic and prosthetic support from birth until function is restored, including coverage for post-adolescence procedures. For many people with craniofacial anomalies, most surgeries occur at a young age; however, there are still procedures and surgeries that may be needed later in life, once growth is complete.

What ELSA does NOT do?

ELSA does not include cosmetic surgery performed to reshape normal structures of the body to improve appearance or self-esteem.

How can I help?

Please join us by sending letters to your legislators to get ELSA passed! We encourage you to include your personal story in our prepared letter. You may also tweet or Facebook message your members of Congress to encourage them to co-sponsor ELSA.