Medicare for All Proposes Coverage for Dental Health

Several Medicare for All proposals set to go before Congress aim to integrate dental care into comprehensive health care. If approved, the bills will secure access to preventive dental services for low-income families regardless of where they live. Health care providers and public health advocacy groups have long supported incorporating oral health care into standard health coverage.

Currently, there are discrepancies in adult Medicare dental coverage on a state-by-state basis. For instance, adults and pregnant women in Ohio and North Carolina are offered robust care, whereas Tennessee’s Medicaid program provides no dental coverage for adults.

Earlier this year, the Children’s Dental Health Project released its “Medicaid Dental Guidance to States: An Opportunity to Aim for Equity” to provide guidance on how state agencies can improve equity in children’s oral health care. The checklist identifies barriers, such as discrepancies between coverage and payment policies within state programs, that prevent enrollees from receiving the full spectrum of dental care their benefits afford.

The Medicare Dental Benefit Act of 2019 (S.22) adds a dental benefit to Medicare Part B covering services that are necessary to prevent disease. The act also covers services that promote oral health and treat emergency conditions. A provision under Medicare Part B signifies that all beneficiaries would receive coverage, including those enrolled in Medicare Advantage plans.

Meg Booth, MPH, executive director of the Children’s Dental Health Project, explains it is time to include oral health care as a part of comprehensive health coverage. “Regardless of income or insurer, people report more significant financial barriers to accessing dental care than any other aspect of health care—even though oral health is a crucial part of overall well-being,” she says.

Compared to individuals with good oral health, patients with poor oral health are more likely to experience a variety of general health issues. For example, untreated dental caries can negatively affect a child’s sleep and overall health, and compromise school performance. For adults, untreated dental diseases can increase the risk of cardiovascular diseases, including heart attacks and stroke.

Providing comprehensive dental care for pregnant women is also essential to keeping mother and baby healthy. Improving a pregnant woman’s oral health can help keep her child healthy in both the short- and long-term, as evidence connects periodontal diseases to preeclampsia and adverse birth outcomes. In addition, the microbial pathogens that cause caries are often passed from mother to child in a process known as vertical transmission.

Providing families with access to quality preventive dental care also helps to reduce expenditures generated by dental-related visits to emergency departments. According to the American Dental Association, Americans spent $2 billion on emergency department visits for dental conditions in 2015.

“Although it may be too early for one coverage expansion proposal to take root, every effort can steer the US health care system toward a plan that better meets the needs of all people. Especially with proposals that rely on a program as influential as Medicare,” says Booth. “It is essential to ensure that any universal coverage strategy doesn’t further entrench a flawed model—one that walls off one part of the body from another, or dices up coverage between children, parents, and other adults upon whom kids count to help them learn and grow.”

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