This bill, titled the "Ensuring Lasting Smiles Act," mandates that group health plans and health insurance issuers provide comprehensive coverage for the diagnosis and treatment of specific congenital anomalies or birth defects. The legislation focuses on conditions that primarily impact the appearance or function of the eyes, ears, teeth, mouth, or jaw , ensuring that individuals with these conditions receive necessary care. The required coverage includes a wide array of medically necessary services aimed at improving, repairing, or restoring normal body functioning or appearance, encompassing reconstructive services and procedures along with treatment for complications. Crucially, it also mandates coverage for adjunctive dental, orthodontic, or prosthodontic support from birth until treatment completion, overriding typical exclusions for such services. The bill further ensures coverage for items and services related to secondary conditions and follow-up treatment associated with the underlying congenital anomaly. It explicitly excludes cosmetic surgery not medically determined to be a result of a congenital anomaly. Cost-sharing for these covered services must be no more restrictive than for other medical and surgical benefits. Health plans and issuers must provide notice of this new coverage by January 1, 2026. These provisions will apply to plan years beginning on or after January 1, 2026, and the Secretary of Health and Human Services is directed to study network adequacy and out-of-pocket costs, reporting to Congress by December 31, 2027.