CHICAGO, US: The American Dental Association (ADA) has urged US lawmakers to extend dental coverage to millions of low-income adults through an expansion of the Medicaid health insurance programme. The association is leading a group of stakeholders who support the Medicaid Dental Benefit Act and say that the pandemic has highlighted the inadequacies that exist in the provision of oral healthcare in the US.
The ADA and more than a dozen other stakeholders wrote to leaders of the US Senate and the US House of Representatives on 7 July, urging them to support the Medicaid Dental Benefit Act (H.R.4439) and the Medicaid Dental Benefit Act of 2021 (S.3166). If passed, the legislation would make it mandatory for state Medicaid programmes to cover adult oral health services and it would increase the amount of federal funding that states receive.
The signatories wrote that the SARS-CoV-2 pandemic has “shone a spotlight on the inadequacies within our social safety net programmes, most starkly in oral healthcare”. They said that a lack of access to dental care benefits had worsened as a result of the pandemic, owing to an increase in Medicaid enrolment and millions of delayed dental appointments.
“[Poor] oral health creates social and economic barriers that prevent many low-income adults from economic advancement” – The American Dental Association
Under current Medicaid legislation, states must provide dental benefits to children, but there are no minimum requirements for the coverage of adult dental care. According to the ADA Health Policy Institute (HPI), in 2021 there were three states (Alabama, Maryland and Tennessee) that provided no coverage for adult dental care and nine states (Arizona, Florida, Georgia, Maine, Mississippi, Nevada, Oklahoma, Texas and Utah) that provided emergency care only. Coverage was limited in 16 states and extensive in 21 states.
“This lack of state coverage is particularly problematic because the millions of adults who rely on Medicaid are the least likely to access dental care (including basic preventive services), face the biggest cost barriers to dental care, and are more likely than their higher income counterparts to experience dental pain, report poor mouth health, and find their lives to be less satisfying due to their poor oral health,” the letter read.
Among the co-signatories were the Academy of General Dentistry, the American Association of Endodontists, the Hispanic Dental Association and the Diverse Dental Society.
A 2021 analysis by HPI showed that paying for dental care for low-income adults was a good investment. It found that the net cost of providing extensive dental coverage to adults in all 28 state Medicaid programmes would be US$836 million (€824 million) per year, or US$4.64 per person enrolled in the programme per month. This included an estimated US$1.1 billion per year in dental care costs and US$273.0 million in annual medical care savings.
HPI explained additional benefits that could be generated by country-wide, extensive dental coverage: “As Medicaid oral health coverage opens the door to regular care in more appropriate and cost-effective settings, fewer people would turn to emergency departments to relieve dental pain. This change could save our health system $2.7 billion annually. Also, poor oral health creates social and economic barriers that prevent many low-income adults from economic advancement. Eliminating these barriers would generate additional savings and empower people to pursue better jobs and careers.”