US SB1677

Requires group health plans and insurers to cover outpatient and inpatient diagnosis and treatment for congenital anomalies or birth defects affecting the eyes, ears, teeth, mouth, or jaw

Covered services include reconstructive procedures, dental/orthodontic/prosthodontic care from birth through treatment completion, and follow-up treatment for secondary conditions related to the defect

Cost-sharing for these services cannot exceed the predominant cost-sharing applied to other medical and surgical benefits under the plan

Excludes cosmetic surgery to reshape normal body structures solely to improve appearance or self-esteem when not related to a diagnosed congenital anomaly

Effective for plan years beginning on or after January 1, 2026, with insurers required to notify participants of this coverage; HHS must report to Congress by December 31, 2027 on network adequacy and patient out-of-pocket cost changes