HI HB2522

Requires the State Auditor to assess social and financial effects of mandating health insurance coverage for medically necessary orthodontic services to treat orofacial anomalies (such as cleft lip or palate) for individuals under 26 years of age.

Proposed mandatory benefit would cover treatment to correct abnormal oral structures, ensure adequate dental health, and improve function of affected structures, without denial based on whether treatment is habilitative or non-restorative.

Mandatory benefit capped at $5,000 maximum per treatment phase with no limits on orthodontist visits; payments for non-orthodontic care do not apply toward the maximum benefit.

Exempts qualified health plans offered through the Hawaii health insurance exchange from requirements exceeding essential health benefits under the Affordable Care Act, though mandate applies to plans outside the exchange.

Auditor must submit assessment report to the legislature no later than 20 days before the 2015 regular session convening with findings, recommendations, and proposed implementing legislation.