WASHINGTON – U.S. Senator Ben Cardin (D-Md.), a member of the Senate Finance Health Care Subcommittee, and Congresswoman Nanette Diaz Barragán (D-Calif. 44) have introduced legislation (S. 97/H.R. 502) that repeals the statutory exclusion on Medicare coverage of dental care and dental prostheses, while creating a specific dental benefit under Medicare Part B. Oral health also is directly related to COVID-19 risk, as poor oral health puts people at a higher risk of contracting and dying from the virus.
Two-thirds of the elderly and individuals with disabilities in the Medicare program, often living on a fixed income, do not have oral health coverage. These beneficiaries struggle to afford and receive the oral health care services they need to stay healthy.
“Good oral health is essential to overall health especially in the midst of a pandemic, but quality oral care can be out of reach for too many of our older Marylanders and others around the nation,” said Senator Cardin. “The federal government has made great strides in our effort to expand guaranteed dental coverage for our children; we must do the same for adults.”
“Dental care should not be a luxury. Adding oral coverage to Medicare will make it accessible for millions of seniors across the country, including many of my constituents in Los Angeles who can’t even see a dentist for emergencies, let alone routine care,” Congresswoman Barragán said.
When individuals forego care, their overall health suffers, worsening oral health conditions that are often painful and chronic diseases such as diabetes and heart disease. About two in three (68 percent) adults aged 65 years or older have gum disease. Expanding Medicare to include a dental benefit could help lower incidents of tooth loss and gum disease in older Americans. According to the Centers for Disease Control and Prevention (CDC), nearly one in five adults over the age of 65 have lost all of their teeth.
Senate cosponsors of S. 97 include Senators Sherrod Brown (D-Ohio), Jeff Merkley (D-Ore.), Chris Van Hollen (D-Md.), Richard Blumenthal (D-Conn.) and Bob Casey (D- Pa.). The original House co-sponsors are Representatives Ro Khanna (Calif.), Robin Kelly (Ill.) and Eleanor Holmes Norton (D.C.). The legislation is supported by FamilesUSA, Justice in Aging and the Center for Medicare Advocacy.
The Medicare Dental Benefit Act (S.97) amends Title XVIII of the Social Security Act to provide for coverage of dental services under the Medicare program. The bill expands covered benefits for dental and oral health services, while also including measures to facilitate implementation and contain costs.
Specifically the bill:
- Repeals the statutory exclusion on Medicare coverage of dental care and dental prostheses.
- Expands Part B benefits to cover dental and oral health services, including routine cleanings and exams, fillings and crowns, major services such as root canals and extractions, emergency dental care, and other necessary services.
- Provides for payment of dental prostheses, including crowns and full and partial dentures.
- Gradually phases in benefits over an 8-year period.
- Ensures adequate reimbursement for dental providers who serve low-income enrollees.
- Requires that the United States Preventive Service Task Force (USPSTF) include at least one oral health professional.