{"format":1,"id":"117-hr-1916","congress":117,"number":"H.R. 1916","kind":"bill","group":"bills","title":"Ensuring Lasting Smiles Act","title_source":"Short Title(s) as Passed House","official_title":"To provide health insurance benefits for outpatient and inpatient items and services related to the diagnosis and treatment of a congenital anomaly or birth defect.","titles":[{"type":"Official Title as Introduced","title":"To provide health insurance benefits for outpatient and inpatient items and services related to the diagnosis and treatment of a congenital anomaly or birth defect."},{"type":"Short Titles from RFS (Referred to Senate) bill text","title":"Ensuring Lasting Smiles Act"},{"type":"Display Title","title":"Ensuring Lasting Smiles Act"},{"type":"Short Title(s) as Passed House","title":"Ensuring Lasting Smiles Act"},{"type":"Short Title(s) as Introduced","title":"Ensuring Lasting Smiles Act"}],"outcome":"passed_house","law_number":null,"introduced":"2021-03-16","chambers":{"house":{"status":"roll_call","date":"2022-04-04","vote":{"id":"117-2022-h109","question":"On Motion to Suspend the Rules and Pass, as Amended","title":"Ensuring Lasting Smiles Act","result":"Passed","yea":310,"nay":110,"present":0,"not_voting":9,"source":"https://clerk.house.gov/evs/2022/roll109.xml"}},"senate":{"status":"na","date":null,"vote":null}},"president":{"status":"na","date":null},"vice_president_tie_breaker":null,"latest_action":{"text":"Received in the Senate and Read twice and referred to the Committee on Health, Education, Labor, and Pensions.","date":"2022-04-05"},"nominees":null,"amendments":[],"other_votes":[],"crs_summary":{"date":"2022-04-04","stage":"Passed House","blocks":[{"k":"h","t":"Ensuring Lasting Smiles Act"},{"k":"p","t":"This bill requires private health insurance plans to cover diagnosis and treatment of congenital anomalies and birth defects, such as reconstructive services and items. Coverage must include services and items that functionally improve, repair, or restore any body part that is medically necessary for normal bodily functions or appearance, as determined by the treating physician. Coverage limits and cost-sharing requirements for such services and items may not be more restrictive than those applicable to all medical and surgical benefits under the plan."}],"words":86},"summary":{"main_subject":{"text":"Requires group health plans and health insurance issuers to cover outpatient and inpatient items and services related to the diagnosis and treatment of a congenital anomaly or birth defect.","cites":[{"label":"Sec. 2","href":"https://www.congress.gov/bill/117th-congress/house-bill/1916/text/eh#H257DA5D1BF66428F9AB9EDF65352CA7B"}]},"core_areas":["Health plan coverage of congenital anomaly and birth defect diagnosis and treatment"],"what_it_does":[{"text":"Amends the Public Health Service Act, the Employee Retirement Income Security Act of 1974 and the Internal Revenue Code of 1986 to require group health plans, and issuers of health insurance coverage where the text names them, to cover items and services related to the diagnosis and treatment of a congenital anomaly or birth defect.","cite":{"label":"Sec. 2","href":"https://www.congress.gov/bill/117th-congress/house-bill/1916/text/eh#H257DA5D1BF66428F9AB9EDF65352CA7B"}},{"text":"Includes within the required coverage any medically necessary item or service to functionally improve, repair, or restore any body part to achieve normal body functioning or appearance, as determined by the treating physician.","cite":{"label":"Sec. 2","href":"https://www.congress.gov/bill/117th-congress/house-bill/1916/text/eh#H257DA5D1BF66428F9AB9EDF65352CA7B"}},{"text":"Allows coverage limits and cost-sharing requirements on this coverage only if they are no more restrictive than the predominant limits and requirements applied to substantially all medical and surgical benefits under the plan or coverage.","cite":{"label":"Sec. 2","href":"https://www.congress.gov/bill/117th-congress/house-bill/1916/text/eh#H257DA5D1BF66428F9AB9EDF65352CA7B"}},{"text":"Defines treatment to include reconstructive services, adjunctive dental, orthodontic, or prosthodontic support, and procedures for secondary conditions and follow-up, and excludes cosmetic surgery performed to reshape normal structures of the body to improve appearance or self-esteem.","cite":{"label":"Sec. 2","href":"https://www.congress.gov/bill/117th-congress/house-bill/1916/text/eh#H257DA5D1BF66428F9AB9EDF65352CA7B"}},{"text":"Requires plans and issuers, within one year after enactment and annually after that, to give each enrollee, participant or beneficiary a written description of these terms in language the typical enrollee can understand.","cite":{"label":"Sec. 2","href":"https://www.congress.gov/bill/117th-congress/house-bill/1916/text/eh#H257DA5D1BF66428F9AB9EDF65352CA7B"}},{"text":"Applies the amendments to plan years beginning on or after January 1, 2024.","cite":{"label":"Sec. 2","href":"https://www.congress.gov/bill/117th-congress/house-bill/1916/text/eh#H257DA5D1BF66428F9AB9EDF65352CA7B"}}],"unexpected":[],"version":{"type":"Engrossed in House","date":"2022-04-04","rule":"passed","href":"https://www.congress.gov/bill/117th-congress/house-bill/1916/text/eh"},"current":true,"model":"claude-sonnet-5-5","approved":"2026-10-15","approved_by":"checks"},"sources":{"congress_gov":"https://www.congress.gov/bill/117th-congress/house-bill/1916","text":"https://www.congress.gov/bill/117th-congress/house-bill/1916/text"},"card":{"image":"card/item/117-hr-1916.png","v":"3363d3a2c256","alt":"Votes on Record. H.R. 1916, 117th Congress: Ensuring Lasting Smiles Act. House: 310 Yea, 110 Nay. Outcome: Passed House, 4 Apr 2022."}}