Oral health, or healthy teeth and gums, is a big part of overall health – with physical, social and emotional impacts. And, oral health also has an enormous financial impact as a leading driver of medical debt.

As part of Community Catalyst’s efforts to alleviate the burden of medical debt, as well as advance solutions to address the underlying drivers of dental debt specifically, we proudly celebrated alongside multi-issue partners last month the Biden administration’s finalized rule that allows states to include coverage for adult dental care as part of the Essential Health Benefits (EHBs).

“Now, it’s time for states to act,” shares Community Catalyst and CareQuest in recent Health Affairs piece.

Recent research finds that 83% of voters support making dental care more affordable by making it a part of what insurance companies must cover. Dental care in the U.S. presents the highest burden of any health care service – with 33% of voters saying they’ve recently skipped out on dental care due to cost and 43% of voters surveyed indicated they had some form of medical debt.

Despite the importance of oral health, millions of people in the U.S. lack access to preventive programs, dental insurance, and dental care – which disproportionately impacts many systemically excluded communities, including Black people, Hispanic people, people with low incomes, rural communities, Tribal communities, and people with disabilities. This has opened the door for the proliferation of predatory, high interest medical credit cards being advertised in dental offices.

If you would like to speak with someone at Community Catalyst about our work to address the medical debt crisis, as well as expand the Essential Health Benefits, please reach out to  jcardinal@communitycatalyst.org.

Key facts:

  • In April 2024, the Biden administration finalized a new rule allowing states to include adult dental services in the list of designated essential health benefits (EHBs) required to be covered by most health plans under the Affordable Care Act (ACA). Previously, states were prohibited from doing so.  This is the first time federal policymakers have acted to expand access to adult dental services in private insurance.
  • This latest move by the Biden administration is part of a larger positive trend to strengthen adult dental access through public health insurance programs. During the past three years, policymakers in 14 states have acted to improve adult dental coverage through their Medicaid programs. The administration also noted that this policy has the potential to improve overall health and quality of life and that the critical advantages to individual, community, and population health are worth the potential systems costs.
  • This new rule holds the potential to make dental coverage available to millions of people who do not have it. According to the 2023 State of Oral Health Equity in America survey from CareQuest Institute for Oral Health, nearly 70 million adults do not have dental insurance.
  • In addition to upfront premium costs, many dental plans do not cover the full array of services people need, resulting in additional out-of-pocket costs and presenting people with an impossible choice: forgo needed dental care or go into debt to pay for it. About half of people with medical debt say dental bills contribute to it, and dental care continues to present the highest financial burden of any health care service.
  • Now, it is up to states to recognize this correlation and take action to fully realize the impact of the inclusion of oral health in overall health care policy. Accessible, equitable, and integrated health care is essential for everyone.