A Democratic bill with 17 Republican cosponsors · See all 54 cosponsors
Last activity — Committee on Health, Education, Labor, and Pensions. Hearings held.
In committee
Introduced and handed to a committee in the chamber it started in.
The committee holds it, and most bills are never heard from again. A hearing or a committee vote would be news; silence is the usual outcome, and it kills the bill without anyone voting against it.
Its path through Congress
- Introduced
- In Committee
What this bill would do
The "Ensuring Lasting Smiles Act" aims to require health insurance coverage for specific medical needs. It mandates that group health plans and health insurance issuers cover items and services related to the diagnosis and treatment of congenital anomalies or birth defects. This coverage specifically targets conditions that primarily impact the appearance or function of the eyes, ears, teeth, mouth, or jaw. The bill includes provisions for reconstructive services, dental support, and treatments for secondary conditions. It also establishes rules for cost-sharing and requires insurers to provide notice to participants.
Yes· 3 of 8
- Scored +7
Would children be better off under this?
The bill protects children by mandating coverage for congenital anomalies from birth.
- Scored +7
Would people with disabilities be better off under this?
The bill ensures medical coverage for conditions that result in physical or sensory disabilities.
- Scored +7
Does this make health care easier to get in general?
The bill significantly improves healthcare access by requiring coverage for the diagnosis and treatment of specific congenital anomalies affecting the eyes, ears, teeth, mouth, or jaw.
The opposite
No question was scored the opposite.
Who it would affect, and how
Potential Positive Impacts for People
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Mandated Coverage for Essential Care: Group health plans and health insurance issuers must provide coverage for outpatient and inpatient items and services related to the diagnosis and treatment of congenital anomalies or birth defects that impact the eyes, ears, teeth, mouth, or jaw (Section 2, a, 1).
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Protection Against Excessive Out-of-Pocket Costs: Cost-sharing requirements, such as copayments or deductibles, cannot be more restrictive than the predominant cost-sharing applied to other medical and surgical benefits under the plan (Section 2, a, 2).
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Comprehensive Reconstructive Support: The bill requires coverage for items or services meant to improve, repair, or restore body parts to achieve normal functioning or appearance, as determined medically necessary (Section 2, a, 3, A, i).
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Continued Dental and Orthodontic Care: Coverage includes adjunctive dental, orthodontic, or prosthodontic support from birth until the medical or surgical treatment of the defect is completed (Section 2, a, 3, A, ii, II).
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Follow-up Care Inclusion: The mandate extends to items and services related to secondary conditions and follow-up treatment associated with the underlying congenital anomaly or birth defect (Section 2, a, 3, A, iii).
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Informed Beneficiaries: Insurers are required to provide notice to participants and beneficiaries regarding these coverage requirements in their service documents by January 1, 2026 (Section 2, a, b).
Potential Negative Impacts for People
- Exclusion of Non-Medical Cosmetic Surgery: The bill specifically excludes coverage for cosmetic surgery performed to reshape normal structures of the body to improve appearance or self-esteem if it is not a result of a medical determination of a congenital anomaly or birth defect (Section 2, a, 3, B).
Groups and Interests Ranking
Every group the model scored this bill for, from -10 to +10. Tap or hover a score for the reason it gave.
- Demographic And Interest Groups
- Would children be better off under this? — The bill protects children by mandating coverage for congenital anomalies from birth. Would people with disabilities be better off under this? — The bill ensures medical coverage for conditions that result in physical or sensory disabilities. Would households on low incomes be better off under this? — Mandated coverage reduces the financial burden of treating congenital anomalies for families. Would middle-income households be better off under this? — It provides certainty in health coverage for specific medical needs. Would people in their twenties and thirties be better off under this? — It provides essential coverage for those living with birth defects.
- Healthcare
- Does this make health care easier to get in general? — The bill significantly improves healthcare access by requiring coverage for the diagnosis and treatment of specific congenital anomalies affecting the eyes, ears, teeth, mouth, or jaw.
- Social Issues And Justice
- Does this expand the rights of people with disabilities? — By mandating coverage for congenital anomalies that manifest as functional disabilities, the bill supports the rights and needs of individuals with such conditions.
- Economy And Finance
- Does this give people more protection from unfair business practices? — The bill improves consumer protection by mandating that insurance plans cover specific congenital anomaly treatments and provide notice of these benefits.
- 9/28/2026
- 1 Cosponsor added.
- 9/17/2026
- 1 Cosponsor added.
- 8/3/2026
- 1 Cosponsor added.
- 7/30/2026
- 1 Cosponsor added.
- 7/16/2026
- 1 Cosponsor added.
- 7/14/2026
- 1 Cosponsor added.
- 5/19/2026
- 1 Cosponsor added.
- 4/13/2026
- 1 Cosponsor added.
- 3/19/2026
- Committee on Health, Education, Labor, and Pensions. Hearings held.
- 3/11/2026
- 1 Cosponsor added.
- 3/4/2026
- 1 Cosponsor added.
- 3/3/2026
- 2 Cosponsors added.
- 3/2/2026
- 2 Cosponsors added.
- 2/10/2026
- 1 Cosponsor added.
- 1/29/2026
- 1 Cosponsor added.
- 1/5/2026
- 1 Cosponsor added.
- 12/9/2025
- 1 Cosponsor added.
- 12/3/2025
- 2 Cosponsors added.
- 11/18/2025
- 1 Cosponsor added.
- 11/6/2025
- 1 Cosponsor added.
- 11/5/2025
- 1 Cosponsor added.
- 11/4/2025
- 1 Cosponsor added.
- 10/29/2025
- 1 Cosponsor added.
- 10/1/2025
- 1 Cosponsor added.
- 9/29/2025
- 4 Cosponsors added.
- 9/17/2025
- 1 Cosponsor added.
- 9/9/2025
- 1 Cosponsor added.
- 9/8/2025
- 1 Cosponsor added.
- 9/2/2025
- 1 Cosponsor added.
- 7/23/2025
- 2 Cosponsors added.
- 7/22/2025
- 1 Cosponsor added.
- 6/25/2025
- 1 Cosponsor added.
- 6/24/2025
- 1 Cosponsor added.
- 6/16/2025
- 1 Cosponsor added.
- 6/9/2025
- 1 Cosponsor added.
- 5/19/2025
- 1 Cosponsor added.
- 5/8/2025
- Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
- 12 Cosponsors added.
- Introduced in Senate
One bill Congress.gov lists as related to this one — companions in the other chamber, earlier versions, and bills this one absorbed or was folded into.
Angela AlsobrooksDemocrat · Maryland
John BoozmanRepublican · Arkansas
John BarrassoRepublican · Wyoming
Michael BennetDemocrat · Colorado
Richard BlumenthalDemocrat · Connecticut
Cory BookerDemocrat · New Jersey
Lisa Blunt RochesterDemocrat · Delaware
Maria CantwellDemocrat · Washington
Susan CollinsRepublican · Maine
Shelley CapitoRepublican · West Virginia
Christopher CoonsDemocrat · Delaware
Kevin CramerRepublican · North Dakota
Steve DainesRepublican · Montana
Tammy DuckworthDemocrat · Illinois
Joni ErnstRepublican · Iowa
John FettermanDemocrat · Pennsylvania
Chuck GrassleyRepublican · Iowa
Kirsten GillibrandDemocrat · New York
Ruben GallegoDemocrat · Arizona
John HickenlooperDemocrat · Colorado
Mazie HironoDemocrat · Hawaii
Martin HeinrichDemocrat · New Mexico
Cindy Hyde-SmithRepublican · Mississippi
James JusticeRepublican · West Virginia
Amy KlobucharDemocrat · Minnesota
Mark KellyDemocrat · Arizona
Angus KingIndependent · Maine
Ben LujánDemocrat · New Mexico
Edward MarkeyDemocrat · Massachusetts
Patty MurrayDemocrat · Washington
Lisa MurkowskiRepublican · Alaska
Christopher MurphyDemocrat · Connecticut
Jeff MerkleyDemocrat · Oregon
Roger MarshallRepublican · Kansas
Bernie MorenoRepublican · Ohio
Alex PadillaDemocrat · California
Gary PetersDemocrat · Michigan
John ReedDemocrat · Rhode Island
Jacky RosenDemocrat · Nevada
Adam SchiffDemocrat · California
Jeanne ShaheenDemocrat · New Hampshire
Dan SullivanRepublican · Alaska
Tina SmithDemocrat · Minnesota
Elissa SlotkinDemocrat · Michigan
Rick ScottRepublican · Florida
Tim SheehyRepublican · Montana
Thomas TillisRepublican · North Carolina
Chris Van HollenDemocrat · Maryland
Ron WydenDemocrat · Oregon
Raphael WarnockDemocrat · Georgia
Peter WelchDemocrat · Vermont
Sheldon WhitehouseDemocrat · Rhode Island
Mark WarnerDemocrat · Virginia
Elizabeth WarrenDemocrat · Massachusetts