Nonsyndromic cleft lip with or without cleft palate (CL/P) is a prevalent congenital anomaly worldwide that poses significant health challenges. Currently, the United States lacks a unified approach to CL/P coverage. This article explores the U.S. medical-legal framework surrounding CL/P, identified via the PubMed, Google Scholar, Lexis, and Westlaw databases. It examines the Affordable Care Act, the Health Insurance Portability and Accountability Act, and state-level variations in CL/P coverage. The findings suggest a need for legal reform to ensure equitable access for patients with CL/P across the United States.
BloomfieldVLiaoC. 113: Global trends in the rate of cleft lip and palate: bridging the gap. Paediatr Child Health. 2015;20(5):e75-e75. doi:10.1093/pch/20.5.e75
Wells-DurandEBuchelATuenYJ, et al.What does cleft lip and palate care cost? The time and economic-associated burden of care from birth to maturity. Plast Surg. 2025;33(1):139-148. doi:10.1177/22925503231203216
5.
McIntyreJKSethiHSchönbrunnerAProudfootJJonesMGosmanA. Number of surgical procedures for patients with cleft lip and palate from birth to 21 years old at a single children's hospital. Ann Plast Surg. 2016;76(Suppl 3):S205-S208. doi:10.1097/SAP.0000000000000765
6.
MullenMCYanFFordMEPatelKGPechaPP. Racial and ethnic disparities in primary cleft lip and cleft palate repair. Cleft Palate Craniofac J. 2021;60(4):482-488. doi:10.1177/10556656211069828
ThompsonJAHeatonPCKeltonCMLSitzmanTJ. National estimates of and risk factors for inpatient revision surgeries for orofacial clefts. Cleft Palate Craniofac J. 2017;54(1):60-69. doi:10.1597/15-206
10.
RochlinDHMaLWSheckterCCLorenzHP. Out-of-pocket costs and provider payments in cleft lip and palate repair. Ann Plast Surg. 2022;88(4):S343-S347. doi:10.1097/sap.0000000000003081
11.
42 U.S.C§ 18022(b).
12.
BarreroCEKavanaghNMPontellME, et al.Associations between Medicaid expansion and timely repair of cleft lip and palate. J Craniofac Surg. 2023;34(7):2116-2120. doi:10.1097/scs.0000000000009524
