WASHINGTON – U.S. Senator Ben Cardin (D-Md.), Chair of the Senate Finance Health Care Subcommittee, introduced legislation today with Representatives Nanette Diaz Barragán (D-Calif. 44) and Robin Kelly (D-Ill.-2) that would create a specific dental benefit under Medicare Part B and repeal the statutory exclusion of Medicare coverage of most dental care and dental prostheses. Their bill, the Medicare Dental Benefit Act of 2023, would require Medicare coverage to include dental and oral health services, such as routine diagnostic and preventive services, basic and major dental services, and emergency care. Currently, Medicare only covers dental treatment when it is necessary for part of a procedure already covered by Medicare.
“Oral health is not a stand-alone issue. It is a vital part of a person’s overall health, and the COVID-19 pandemic only exacerbated the challenges we face in ensuring every Marylander and all Americans have access to the dental care and treatment they deserve,” said Senator Cardin. “We must decide how we want to move forward as a country. In order to achieve better outcomes, me must invest in our people and expand access to dental care, which will improve the overall health of millions.”
“Studies show that oral health is critical to overall health – oral healthcare should not be a luxury. Medicare’s lack of a dental benefit significantly contributes to poor health outcomes for older Americans and those who are disabled, especially among Black and Hispanic communities,” Congresswoman Barragán said. “Approximately 6 in 10 Hispanic Medicare beneficiaries could not afford not see a dental provider in 2021 and nearly 1 in 3 Hispanic seniors have untreated tooth decay. It’s time that Congress mandate Medicare dental coverage. This bill will make oral healthcare accessible for millions of people across the country, including many of my constituents in California’s 44th district, and allow them to get the care they need.”
“Proper dental care is not a luxury; it’s a basic necessity for maintaining overall health. This legislation is necessary to expand Medicare’s dental benefit and improve the lives of millions, especially seniors and individuals with disabilities,” said Congresswoman Robin Kelly. “Congress must recognize oral health as a foundational aspect of well-being for every American. I am proud to lead this effort to ensure comprehensive dental healthcare for millions of Americans.”
According to the Wisdom Tooth Project of Oral Health America, nearly 70 percent of seniors have inadequate access to dental insurance and do not receive dental care on a yearly basis.
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. More than 70 percent of 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), more than one-quarter of adults over age 65 (26%) have 8 or fewer teeth and nearly 1 in 6 adults (17%) over the age of 65 have lost all of their teeth.
“In this nation, our health should not depend on our wealth and that includes our oral health. Oral health is key to overall health and wellness, employment opportunities, economic stability, and social connectedness. One of the most impactful steps we can take is to provide comprehensive dental coverage for those why rely on Medicare for their health coverage,” said Melissa Burroughs, Director of Strategic Partnerships and Oral Health for All Campaign, Families USA.
The Medicare Dental Benefit Act of 2023 is supported by FamiliesUSA, Carequest, Institute for Oral Health, Center for Medicare Advocacy, Community Catalyst, Gerontological Society for America, Justice in Aging and the Medicare Oral Health Coalition. Senate cosponsors include Senators Richard Blumenthal (D-Conn.), Ed Markey (D-Mass.) and Jeff Merkley (D-Ore.).
The Medicare Dental Benefit Act of 2023 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.
The full text is available here. 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.