Dental coverage is having a moment, both in state governments and at the federal level. In Virginia, for example, July 1, 2021 marked the start of new, robust dental benefits for people with low incomes enrolled in Medicaid. In Congress, lawmakers have been working to expand oral health coverage for older adults who use Medicare, as leaders realize that lacking such benefits often means foregoing needed care. Thankfully, federal policymakers are also responding to the oral health benefit gaps facing adults enrolled in Medicaid. This week, Rep. Nanette Diaz Barragán (D-CA-44) announced the introduction of a new bill, the Medicaid Dental Benefit Act.
This measure would finally ensure oral health coverage for adults who rely on Medicaid for their health care. Like their elder peers in Medicare, many parents, young adults, and other individuals working paycheck to paycheck have been locked out of dental coverage for far too long. As of this writing, five members of Congress have cosponsored the bill.
“We know that oral health is essential to overall health and economic well-being; and yet millions of adults who count on Medicaid can’t access dental coverage due to where they live. This injustice most hurts people with low incomes, people of color, rural and tribal communities, and those with disabilities,” said Emily Stewart, executive director of Community Catalyst. “By advancing the Medicaid Dental Benefit Act, Congress can fix this gaping hole in coverage and access to care while advancing racial and economic justice.”
Specifically, the Medicaid Dental Benefit Act would:
End the confusing patchwork of Medicaid adult dental coverage that currently exists from state to state by making adult dental services a mandatory coverage category for all adults in Medicaid;
Ensure that everyone gets the care they need by establishing a more comprehensive definition of Medicaid dental and oral health services for adults;
Help states make this benefit a reality by increasing federal matching funds (FMAP) for Medicaid dental services;
Set up standards for good care by establishing oral health quality measures for the adult population; and
Account for racial equity and disparities, investing in outreach efforts to connect adults in underserved communities to oral health care and funding culturally competent and linguistically appropriate provider education.
This bill is particularly important for adults who have been marginalized by entrenched racism and economic inequality. These communities confront the steepest structural and historic hurdles to dental services today. As just one example, among adults facing cost barriers to dental care, racial disparities have only widened in the past decade. By securing adult dental coverage in Medicaid, the Medicaid Dental Benefit Act would lift this barrier and advance health equity.
Adding adult dental coverage to Medicaid would also improve people’s overall health and reduce medical spending, helping secure a lasting economic recovery from the pandemic. Our blog recently reported that Community Catalyst, Families USA, and the American Dental Association’s Health Policy Institute published new research showing that extending comprehensive oral health coverage to all adults enrolled in Medicaid could save at least $273 million in overall health care spending. Much of these gains would come from the overall health benefits that result from better oral health. For example, good oral health can help people better manage chronic conditions like diabetes and heart disease. It can also reduce the risk of dangerous, costly pregnancy complications.
And, this number doesn’t even account for other funds saved from extending such coverage, which could be in the billions — from helping states reduce their overall dental care spending, to averting other unnecessary health care costs, such as hospital emergency department visits for dental pain.
Community Catalyst urges members of Congress to advance this bill. At the same time, we recognize that guaranteeing adult dental coverage is only one part of a comprehensive set of solutions needed to overcome all the roadblocks that keep people from having good oral health. We remain strong advocates for other policies proven to help people who have been economically marginalized get timely, high quality care in their communities. Such policies include expanding the oral health workforce to include dental therapists and boosting resources for teledentistry, among other proposals.
We applaud Rep. Barragàn for leading the Medicaid Dental Benefit Act and her colleagues working to advance it. In addition to advancing a sustainable economic recovery from the pandemic, the bill would ensure that where you live, your race or background, or how much money you have is not a barrier to accessing comprehensive dental care. It is a cost-effective way to support better oral and overall health for adults and families nationwide. As more people get the timely oral health care they need, we can build healthier communities with greater prosperity to help all of us flourish.