(This story has been updated to add new information.)
Courtney Sands couldn’t escape the throbbing pain in the back of her mouth: The Pennsylvania mom needed root canal treatment and crowns on two back teeth to get rid of the infection that was causing the pain.
But a visit to an endodontist this spring produced a different kind of pain familiar to many dental patients: Before the specialist could begin filing away at the tooth, the office staff asked the patient for thousands of dollars in advance.
Sands returned to the hospital a week later to get crowns on two back teeth. Though she had dental insurance through her job and her husband, she had to pay before getting treatment, so she ended up paying more than $6,000 on her high-interest credit cards.
Dental insurance plans ultimately reimbursed her for only a small portion of what she paid to treat her oral health emergency: One dental insurer paid her $1,000, another paid $395.
Sands might be considered one of the lucky Americans when it comes to dental care. More than half of U.S. adults have No consistent access Attention to dental care is low, and problems like oral infections, if left untreated, can have a negative impact on overall health. Despite the barriers many face to accessing these routine care, dental coverage has little support among political leaders.
Vice President Kamala Harris and former President Donald Trump have been locked in fierce sparring over abortion and lowering insulin prices, but one health-related topic neither candidate has emphasized is how to provide dental care to the tens of millions of uninsured Americans.
After all, covering oral care is a popular stance: An overwhelming majority of voters want their leaders to shore up the nation’s flawed dental health system.
Surveys show that about 90% of voters support adding dental benefits to Medicare. vote The survey of 1,000 registered voters conducted this summer by the CareQuest Oral Health Institute and the Oral Health Advancement Equity Network, nonprofits that focus on oral health access and equity, found that the issue has near-universal support among Democrats and 85% support among Republicans.
Neither Ms. Harris nor Mr. Trump has mentioned expanding dental coverage in their policy platforms or major speeches. Priorities for both candidates in the Sept. 10 debate included grocery prices and the future of Obamacare, but neither has consistently championed dental care or oral health.
The need is undeniable. Approximately 69 million American adults Dental Insurance According to CareQuest, more than one million people did not have access to regular oral health care last year. Loss of dental insurance That comes as states began ending Medicaid coverage last year for people who signed up during the COVID-19 pandemic.
Medicare, the federal health insurance program primarily for adults age 65 and older, does not cover routine dental care. Nearly half According to an analysis by KFF, a nonprofit health policy group, as of 2018, 70% of people with Medicare hadn’t visited a dentist in over a year.
“Too many people in this country find oral health care too expensive and out of reach,” said Melissa Burrows, public policy director at CareQuest, “and yet this issue has really been pushed to the back burner in policy conversations and political efforts to solve it.”
More important than abortion?
An online poll by CareQuest asked voters to rank the nine health issues they found most important: adding dental coverage to Medicare was rated the second most important issue, behind lowering prescription drug costs.
Voters prioritized Medicare dental benefits over topics frequently raised by Democratic and Republican presidential candidates, such as abortion rights and the future of Obamacare. Voters also prioritized dental benefits over access to mental health services, the cost of insulin, health care transparency, the opioid crisis, and changes to Medicare eligibility.
“This is one of the most popular things in health care, according to voters, and we can’t continue to let this fade into the background,” Burrows said.
Consumers who enroll in private Medicare Advantage plans typically have the option to choose a plan that covers dental, hearing, and vision care, although terms and coverage vary by plan and vendor. Seniors who enroll in traditional government-run Medicare can purchase dental insurance. Still, Nearly half According to KFF, as of 2019, 70% of people enrolled in Medicare did not have dental insurance.
2024 Democratic Party Platform It calls for adding dental, vision and hearing coverage to Medicare, but doesn’t detail how those benefits would be paid for other than “making the wealthy and big corporations pay their fair share.”
Republican Plan There is no mention of dental care or oral health.
CareQuest said additional polling found broad support for adding dental benefits to Medicare among voters in three focused states: More than 90 percent of voters in Michigan, Ohio and Pennsylvania supported adding dental benefits to Medicare.
That’s not surprising for Sands, who lives in Factoryville, Pennsylvania, northwest of Scranton. She works as a nurse and her husband has steady employment. But the out-of-pocket expenses for her dental emergency have left her with less cash to buy materials to continue her DIY home improvements. She said she’s prioritizing paying off her credit card balances.
Congress could tackle dental care reform
While dental care has not been a topic of the party’s election platform, the Biden administration and lawmakers have proposed ways to close the dental care gap.
administration The rules were finalized The bill, passed earlier this year, would give states the option to add adult dental coverage as part of ACA plans. While the 2010 health insurance law did not cover dental coverage for adults, states were required to offer pediatric dental care as an essential health benefit in ACA plans.
Two related bills in Congress would expand dental insurance through Medicare, Medicaid and the Veterans Administration, and increase the number of dentists, dental hygienists and dental therapists nationwide. Vermont Independent Sen. Bernie Sanders introduced the Comprehensive Dental Reform Act of 2024 in the Senate in May. On Tuesday, Michigan Democrat Sen. Debbie Dingell introduced an amendment to the bill in the House of Representatives.
Neither bill is scheduled for a vote, and the Congressional Budget Office has not estimated how much the bills would cost.
Dingell said too many people avoid the dentist because they’re afraid of the bill.
“Lack of dental care can worsen other serious medical conditions, but without adequate insurance coverage, millions of Americans don’t get the critical oral care they need,” she said when introducing the bill last week.
Groups representing dentists say they support efforts to expand Medicare dental coverage.
In a statement to USA Today, the American Dental Association said it supports comprehensive dental benefits for low-income adults and seniors. The association also supports legislation to provide adult dental insurance to Medicaid recipients and reauthorize grant programs to help dentists practice in medically underserved areas, including rural communities.
“Comprehensive dental coverage means low-income seniors can have a full range of affordable dental services they need to maintain healthy mouths that allow them to eat and sleep comfortably, free from chronic pain,” the ADA said.
Sands, who lives in Pennsylvania, knows how important dental care is to overall health, and she’s grateful she was able to get financing to go to the dentist. Others in her community aren’t as fortunate.
“I know people who have been in pain for years and haven’t gone to the dentist,” Sands says. “I’ve seen people with swollen gums and pus coming out of their mouths, and there’s nothing they can do.”
Have you ever struggled to get dental care because of cost or lack of health insurance? Tell consumer health reporter Ken Alltucker at [email protected] about your experience..
