Will Health Reform Include Dental Insurance Coverage?
If the American Dental Association gets its way, the new health insurance reform plan will include dental care. If such an option were to be added to the final bill, it has the potential to cover 108 million Americans who have no dental insurance, approximately 2.5 times the number who have no health insurance.
As the proposed Health Insurance Exchange stands now, the proposed public option in one House bill would extend dental care coverage to children younger than 21 years of age, while adults could get coverage under a public plan that would cost more. Currently 26 million children do not have dental insurance. Information about this proposal can be found in HR3200 on pages and 28 and 86-87.
One reason the addition of dental coverage to health insurance reform seems unlikely is that it has never been a part of Medicare and it is poorly funded in Medicaid, which provides dental care to underprivileged children. Yet according to the Centers for Medicaid and Medicare Services, only 37 percent of children who are eligible through Medicaid to visit a dentist ever do so.
An argument could be made that adding dental coverage to any health insurance reform package could save money in the long run. A 2000 report from the American Academy of Pediatric Dentistry compared Medicaid reimbursement for emergency room care versus dental office visits over three years. While Medicaid reimbursement averaged about $6,498, preventive treatment averaged $660.
Yet it is getting more difficult to find a dentist who accepts Medicaid. The reason appears to be one of economics: dentists simply are not getting reimbursed enough to make them want to participate. (To find a Medicaid-participating dentist in your area, you can visit the government’s Insure Kids Now website.)
And what about adult dental insurance coverage? Among adults, oral cancer kills more Americans than cervical cancer, and there is evidence that oral infections have an impact on pregnancy outcomes and complicate chronic diseases such as diabetes. Even among adults who have health insurance, dental coverage is rarely included. About 82 million adults do not have dental insurance.
The American Dental Association (ADA) will continue to make its case. As the ADA House of Delegates said in a policy statement last year, “No law, regulation or mandate will improve the oral health of the public unless policymakers, patients and dentists work together with a shared understanding of the importance of oral health and its relationships to overall health.” It remains to be seen whether dental coverage in any form will be a part of the health insurance reform bill.
American Dental Association website, “Health care reform policy,” Nov. 4, 2008