ADEA supports adding dental benefit to Medicare

2021 09 15 16 01 9325 Men Women Senior Elderly 400

The American Dental Education Association (ADEA) has come out in support of adding a dental benefit to Medicare. A month ago, the ADEA told lawmakers that adding coverage under Medicare Part B, which is part of a U.S. congressional budget proposal, would be problematic.

In September, the ADEA, the ADA, the Academy of General Dentistry, and eight other dental professional organizations sent a letter to Congress, explaining their opposition to adding a dental benefit to Medicare Part B. In the letter, the organizations stated that expanding benefits within Part B "would not adequately meet the needs of our dentists and Medicare patients."

The ADEA appears to have clarified and strengthened its position on dental Medicare, based on a press release the group issued on October 12.

"We encourage the adoption of legislation that expands Medicare coverage to a broad range of oral health care services for all and provides reimbursement for those services at rates commensurate with the high quality of care provided," the association stated.

Despite the stronger wording to include care for all, leadership at the ADEA said the organization's position on dental Medicare coverage has not changed.

"ADEA has not changed its position on a dental benefit in Medicare," Dr. Karen P. West, president and CEO, said in a statement. "We firmly believe in it and support it as being available for everyone."

Recognizing disparities

In its announcement of support, the ADEA cited a report about the economic well-being of U.S. households in 2020 by the Board of Governors of the Federal Reserve System. Dental care was the most frequently skipped form of care due to an inability to pay, according to the report.

Additionally, oral healthcare is vital to general health, and people who are 65 and older and those with disabilities continue to have difficulty accessing dental care, the ADEA stated. This puts these vulnerable populations at risk of complications from other chronic health conditions, including diabetes and heart disease, which leads to higher healthcare expenses and strains emergency rooms that are often "ill-equipped" to meet the dental needs of these patients, according to the association.

"Congress has the historic and unprecedented opportunity to recognize that oral health is essential to whole health and warrants creating such a benefit in Medicare," the ADEA stated in the release.

The ADEA isn't the only dental organization to speak out in favor of adding dental benefits to Medicare. The American Dental Hygienists' Association (ADHA) has called on hygienists to contact their U.S. representatives and ask them to support oral health coverage in Medicare.

Is a dental benefit slipping away?

As organized dentistry continues to debate dental Medicare benefits, the future of any dental coverage in Medicare may rest on shaky ground. The U.S. House of Representatives plans to shave about $1 trillion in spending from the $3.5 trillion social spending bill to garner enough support for the package.

Adding dental as well as hearing and vision benefits to Medicare Part B is estimated to cost more than $350 billion over a decade. The price tag is a major hurdle to getting the budget package approved.

More progressive factions of the Democratic party believe costs can be controlled by authorizing the new benefits for a handful of years. They hope that the dental, vision, and hearing benefits would rise in popularity among constituents, which would force future lawmakers to renew them. On the other hand, centrist Democrats believe the benefits should be means-tested, which means only the poorest constituents would receive coverage.

The means-tested approach is not far off from a proposal made by the ADA. Since August, the ADA has proposed that the government provide comprehensive dental benefits only for low-income seniors in a separate Medicare program.

Under the ADA's proposed program, dental benefits would be provided to seniors with incomes up to 300% of the U.S. poverty guidelines. The ADA has argued that adding a dental benefit to Part B would mandate significant administrative, programmatic, and technical requirements that wouldn't best serve older patients and would fail to reimburse dentists adequately.

Even if Democrats reach an accord, Republican lawmakers are expected to try to block the proposed spending plan.