Among the many unknowns that come with the implementation of the Patient Protection and Affordable Care Act is one that could hit consumers right in the teeth: orthodontic reimbursement. Pediatric dental, says Evelyn Ireland, executive director at the National Association of Dental Plans, isn’t going anywhere, but parents and others planning on braces should also brace for some cost-shifting.

“Orthodontia is one of the big coverage differences that [may] occur for pediatric dental,” Ireland says. “Pediatric dental in the proposed rules is defined as any enrollee up to [age] 19. So, the way [PPACA] is structured, pediatric dental is a benefit that is described as part of the essential health benefits that will be offered in the small group and individual market. Of course, the small group market includes exchanges.”

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