H.R. 3277 — Ensuring Lasting Smiles Act

This section requires group health plans and health insurance issuers offering group or individual health insurance coverage to cover outpatient and inpatient items and services for the diagnosis and treatment of congenital anomalies or birth defects primarily impacting the appearance or function of the eyes, ears, teeth, mouth, or jaw—including reconstructive procedures, adjunctive dental, orthodontic, or prosthodontic support from birth until treatment completion (notwithstanding typical plan exclusions for non-congenital dental care), and related secondary conditions—with cost-sharing no more restrictive than that applied to substantially all other medical and surgical benefits (excluding cosmetic surgery). It further requires such plans and issuers to provide notice of this coverage in plan documents beginning January 1, 2026, and defines "congenital anomaly or birth defect" as a prenatal structural or functional anomaly (e.g., due to genetic factors, environmental exposures, or unknown causes) that may manifest as abnormal structures, disabilities, syndromes, or health problems at any life stage.