Comprehensive dental coverage gaining traction in Congress

Oct 18, 2024

Last month, Rep. Debbie Dingell, D-Michigan, introduced a new bill in the House to profoundly expand dental coverage for millions of Americans through The Comprehensive Dental Care Reform Act of 2024.

The bill is a clean companion to similar legislation brought forward by Senator Bernie Sanders, D-Vermont, which would expand coverage for individuals in Medicare, Medicaid, the individual market and the Department of Veterans Affairs.

“A lack of dental care can worsen other serious medical conditions, but without adequate coverage, millions of Americans go without the critical oral care they need,” said Dingell in a statement. “This comprehensive legislation will make it easier for Americans to get the dental care they deserve, by expanding coverage and increasing care providers, especially in rural and underserved communities.”

The legislation accomplishes a number of objectives, said Melissa Burroughs, director of public policy for CareQuest Institute for Oral Health, a nonprofit advocating for dental access.

First, it adds dental care as a benefit within Medicare. CareQuest estimates 24 million Americans do not have dental coverage through Medicare.

The bill also adds dental coverage for adults in Medicaid, instead of leaving this determination up to states, and would establish adult dental benefits as an essential health benefit through the Affordable Care Act.

Additionally, veterans would no longer find it harder to qualify for dental care than medical care through the VA.

“Those are huge gaps that many oral health advocates have been working for decades to address, and this does it all in one package,” said Burroughs.

She does not expect dental care legislation to advance in Congress this year, outside of some priorities that may get included in an end-of-the-year package. She expects any comprehensive dental bill would need to be included in a larger healthcare package, so its costs can be offset by savings gained from prescription drug pricing or site-neutral payment reform.

CareQuest has worked with and supported Sanders on these issues, but Dingell’s bill is the first time in years that a companion bill has been introduced in the House.

Rep. Elijah Cummings, D-Maryland, was the House leader on dental care reform, and the movement struggled to regain his footing once he died in October 2019, Burroughs explained. The Maryland Dental Action Coalition credited (PDF) Cummings as a “strong advocate” for better access to oral health.

But the legislation is picking up momentum, particularly among Democrats.

The Senate HELP Committee hosted a hearing on dental affordability and access in May, and the Biden administration has included dental provisions in the Medicare Physician Fee Schedule for several years.

“The initial example was if you’re getting an organ transplant and you have a dental infection that will prevent you from getting your transplant, you can have that dental infection treated and that will be covered by Medicare,” said Burroughs.

Sen. Sanders appeared on comedian Theo Von’s podcast, This Past Weekend, in August, where he said expanding Medicare to cover dental, hearing and vision is a first step toward reforming the American healthcare system. That policy position was included in the Democratic Party platform (PDF) this year.

Yet presidential candidates Donald Trump and Kamala Harris have not discussed dental care on the campaign trail. This is despite polling from CareQuest showing nine in 10 voters support adding a dental benefit to Medicare, including 85% of respondents who voted for Trump in 2016 and 2020. Dental coverage is equally popular in the battleground states of Michigan and Pennsylvania.