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 already passed in the House of Representatives, and has strong bipartisan support from 42 cosponsors in the Senate as of November 11th. Over 70 patient advocacy and health care professional organizations have also supported this legislation. Current Cosponsors in the Senate include: Sen. Ernst, Joni [R-IA] Sen. Brown, Sherrod [D-OH] Sen. Murkowski, Lisa [R-AK] Sen. Klobuchar, Amy [D-MN] Sen. Marshall, Roger [R-KS] Sen. Shaheen, Jeanne [D-NH] Sen. Wicker, Roger F. [R-MS] Sen. Whitehouse, Sheldon [D-RI] Sen. Tillis, Thomas [R-NC] Sen. Stabenow, Debbie [D-MI] Sen. Cramer, Kevin [R-ND] Sen. Van Hollen, Chris [D-MD] Sen. Boozman, John [R-AR] Sen. Peters, Gary C. [D-MI] Sen. Collins, Susan M. [R-ME] Sen. Markey, Edward J. [D-MA] Sen. Capito, Shelley Moore [R-WV] Sen. Booker, Cory A. [D-NJ] Sen. Graham, Lindsey [R-SC] Sen. Smith, Tina [D-MN] Sen. Grassley, Chuck [R-IA] Sen. Sinema, Kyrsten [D-AZ] Sen. Moran, Jerry [R-KS] Sen. Murphy, Christopher [D-CT] Sen. Daines, Steve [R-MT] Sen. Blumenthal, Richard [D-CT] Sen. Braun, Mike [R-IN] Sen. Reed, Jack [D-RI] Sen. King, Angus S., Jr. [I-ME] Sen. Fischer, Deb [R-NE] Sen. Cardin, Benjamin L. [D-MD] Sen. Sullivan, Dan [R-AK] Sen. Merkley, Jeff [D-OR] Sen. Hawley, Josh [R-MO] Sen. Bennet, Michael F. [D-CO] Sen. Hyde-Smith, Cindy [R-MS] Sen. Casey, Robert P., Jr. [D-PA] Sen. Cassidy, Bill [R-LA] Sen. Kennedy, John [R-LA] Sen. Leahy, Patrick J. [D-VT] Sen. Warren, Elizabeth [D-MA] Sen. Barrasso, John [R-WY]

• The “Ensuring Lasting Smiles Act” or ELSA was reintroduced by Senators Tammy Baldwin (D-WI) and Joni Ernst (R-IA) and Representatives Anna Eshoo (D-CA) and Drew Ferguson (R-GA) on March 16th, 2021 (H.R.1916/S.754). The house bill (H.R.1916) was passed with bi-partisan support 310-110 on April 4, 2022.
• Cleft lip and cleft palate (CL/CP) can occur isolated or as part of a syndrome, and are among the most common facial birth defects in the United States. The impact of CL/CP goes beyond just the facial appearance, where studies have shown that self-esteem, academic performance and social relationships are also affected. Patients with CL/CP undergo multiple reconstructive operations throughout childhood and adolescence to restore function as well as improve appearance. The lifetime cost of treating a child with an orofacial cleft approximates $100K.
• Most states and health plans will include coverage for congenital anomalies. However, despite having coverage, insurance companies are still able deny claims by categorizing treatment as cosmetic or not medically necessary. This practice places the financial burden on families to make difficult decisions that impact the long term well being of their children.
• ELSA works to close loopholes that allow insurance companies to deny medically and dentally necessary treatment and services for patients with various conditions. Importantly, ELSA includes coverage for post-adolescence procedures. ELSA works to alleviate the financial hardship for people with CL/CP and craniofacial anomalies and ensure they have continued support for medical and dental needs beyond childhood.
• ELSA includes services performed to improve, repair, or restore bodily function or performed to approximate a normal appearance, due to a congenital anomaly or birth defect, and includes treatment to any and all missing or abnormal body parts (including teeth, the oral cavity, and their associated structures). ELSA does not include cosmetic surgery performed to reshape normal structures of the body to improve appearance or self esteem.
• ELSA has bipartisan support strong bipartisan support from 42 cosponsors in the Senate as of November 11, 2022.