Courtney Sands couldn’t escape the pain in the back of her mouth. A mother in Pennsylvania needed root canals and crowns for two molars to remove an infection that was causing pain.
But a trip to the endodontist this spring brought on a different kind of pain — one that has become familiar to many dental patients. Before the engineer could start digging, the workers in his office demanded that he pay thousands of dollars in advance. He returned a week later to pick up the crowns for his other double row. Although she had dental insurance through her job and her husband’s, she had to pay before she could get care. So he charged more than $6,000 on a high-interest credit card.
Dental insurance plans ended up reimbursing him for a fraction of the money he had paid to treat his emergency. One dental insurance carrier offered him $1,000, another $395.
Americans may be considered among the lucky Americans when it comes to dental care. More than half of US adults do not have access to regular dental care, and untreated issues such as oral infections can harm overall health. Although many people face these barriers to regular care, dental care has gained little traction among political leaders.
Vice President Kamala Harris and former President Donald Trump traded barbs on abortion and lowering insulin prices. Another health-related issue that no candidate has highlighted: How to expand dental care to tens of millions of uninsured Americans.
Covering oral care, it turns out, is a popular position: a large number of voters want leaders to improve the state’s dental care system.
Nearly nine in 10 voters support expanding dental benefits to Medicare, according to a survey of 1,000 registered voters commissioned this summer by the nonprofit CareQuest Institute for Oral Health, which focuses on access. and equity, and the Oral Health Progress and Equity Network. The issue has near-universal support among Democratic voters and 85% support from Republicans.
Neither Harris nor Trump mention the dental extension in their platforms or major speeches. Key points for the candidates in their Sept. 10 included grocery prices and the future of the Affordable Care Act, but none addressed dental care or oral health.
Its necessity cannot be denied. About 69 million US adults did not have dental insurance or access to oral health care last year, according to CareQuest. Millions more lost their dental insurance last year when states began canceling Medicaid coverage for people who signed up during the COVID-19 pandemic.
Medicare, a health insurance program primarily for adults 65 and older, does not provide regular dental coverage. Nearly half of Medicare enrollees had not visited a dentist in more than a year as of 2018, according to a survey by KFF, a health policy organization.
“Too many people in this country have found oral health care too expensive and out of reach,” said Melissa Burroughs, director of public policy at CareQuest. “Yet this issue is still far behind when it comes to policy discussions and political commitment to address it.”
More important than abortion?
CareQuest’s online survey asked voters to rank the nine health topics they consider most important. Adding dental coverage to Medicare has placed the second most important topic, only following the low cost of prescription drugs.
Voters have put Medicare dental benefits ahead of abortion rights and the future of the Affordable Care Act, topics that get a lot of air time with Democratic and Republican presidential rivals. Voters also prioritized dental benefits over access to mental health services, insulin costs, medical billing transparency, the opioid crisis and Medicare eligibility changes.
“This is one of the most popular things in health care, according to voters, and we can’t let it continue to fade into the background,” Burroughs said.
Consumers who enroll in private Medicare Advantage plans often have the option of choosing plans that cover dental, hearing and vision care, but terms and coverage vary by plan and provider. Adults enrolled in traditional government-run Medicare can purchase dental insurance. However, nearly half of Medicare enrollees did not have dental coverage as of 2019, according to KFF.
The 2024 Democratic Party platform calls for adding dental, vision and hearing to Medicare, however, it does not explain how it would pay for such benefits, other than “making the wealthy and big businesses pay a portion their right.”
The Republican plan does not address dental care or oral health.
CareQuest said other polls show voters in three closely watched states support Medicare dental benefits. More than 90% of voters in Michigan, Ohio and Pennsylvania supported adding dental benefits to Medicare.
That’s no surprise to Sands, who lives in Factoryville, northwest of Scranton. She works as a nurse and her husband also has a steady job. But the out-of-pocket costs of his dental emergency mean they have less money to pay for supplies to continue your home renovation. He said he was ahead of paying his credit card balance.
Congress can pass dental care reforms
Although dental care has not been at the forefront of the party’s campaign rhetoric, the Biden administration and members of Congress have proposed ways to fill dental gaps.
The administration finalized legislation earlier this year that would have given states the option to increase dental insurance coverage for adults as part of their Affordable Care Act plans. The 2010 health care law did not extend dental coverage to adults, but states were required to offer pediatric dental care as a health benefit for ACA purposes.
The two congressional bills would increase dental coverage through Medicare, Medicaid and the Veterans Administration and increase the number of dentists, dental hygienists and dentists nationwide. Bernie Sanders, an Independent from Vermont, introduced the Comprehensive Dental Care Reform Act of 2024 in the Senate in May. On Tuesday, Rep. Debbie Dingell, D-Michigan, introduced a version of the bill in the House.
No bill is scheduled for a vote, and the Congressional Budget Office has not yet estimated how much the legislation would cost.
Dingell says too many people avoid the dentist because they fear the bill they will receive.
“Lack of dental care can worsen some serious medical conditions, but without adequate coverage, millions of Americans are missing out on the important oral care they need,” he said when introducing the bill last week.
Associations representing dentists say they support efforts to expand Medicare dental coverage.
The American Dental Association supports more dental benefits for seniors and low-income seniors, said Katherine Merullo, the ADA’s senior director of public affairs and research.
In a statement, Merullo said focusing on dental coverage for low-income seniors will improve health equity. The dental association also supports bills that would provide dental coverage for adults on Medicaid and authorize a grant program for dental providers to work in underserved areas, including rural areas. .
“Comprehensive dentistry means providing low-income people with high incomes the affordable dental services they need to have a healthy mouth,” Merullo said. out of chronic pain and able to eat and sleep comfortably,” said Merullo.
A Pennsylvania Sands resident knows how important dental access is to overall health. He is thankful that he had the opportunity to get a loan to see a dentist. Others in his village are not so lucky.
“People I know have gone years without seeing a dentist, even though they are in pain,” said Sands. “I’ve seen people with swollen gums, pus coming out of the mouth. There’s nothing they can do.”
Have you had trouble getting dental care because of the cost or lack of health insurance? Please share your story with consumer health reporter Ken Alltucker, alltuck@usatoday.com.
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