Oral Health Organizations Urge Congress to Strengthen Extensive Adult Dental Benefits for All State Medicaid Programs

BOSTON–The Oral Health Response Workgroup, a collection of leaders and organizations from across the dental industry, is calling on Congress to improve oral health equity and access by including extensive adult dental benefits in all state Medicaid programs.

“Oral health is the top unmet health need”

The Workgroup recently released a community statement affirming that this change will promote positive health outcomes, address health inequities, and curb health care costs.

“Access to affordable oral health care is out of reach for millions of low-income people, people with disabilities, communities of color, LGBTQIA+ people, and tribal and rural communities,” said Myechia Minter-Jordan, MD, MBA, president and CEO at CareQuest Institute for Oral Health®. “Congress has the opportunity to change that by ensuring that all state Medicaid programs offer extensive dental benefits to all members. This is a chance to meaningfully address long-standing health disparities that have existed in this system for far too long. We stand ready to serve as a resource and to work with Congress to ensure improved health outcomes for all communities.”

Medicaid is a key source of health care coverage for more than 80 million people in the United States, but dental coverage for adult Medicaid beneficiaries is optional for states. While most states provide at least emergency/urgent dental benefits (defined differently by states) for adults, nearly one-third of all states do not provide dental care beyond emergency procedures. According to a new Medicaid Adult Dental Coverage Checker, 47 state Medicaid programs are not currently offering dental benefits sufficient to maintain optimal oral health.

“Oral health equity in this country is a very real issue and is exacerbated within the Medicaid population,” said Ann Lynch, director of advocacy for the American Dental Hygienists’ Association. “Virtually all dental disease is preventable. In the US, it is incumbent on us to make the investment to better the lives of all.”

In its community statement, the Oral Health Response Workgroup stressed the relationship between oral health and overall health and the need for Medicaid programs to address whole-person health. When whole-person health is addressed, the whole community benefits by lower health care costs, increased employability, and healthy applicants across industries.

The Workgroup also highlighted that access to routine, preventive dental care can offset the cost of expensive and unanticipated problems in chronic disease maintenance in conditions such as diabetes, heart disease, and behavioral health conditions. A recent study conducted by the American Dental Association Health Policy Institute estimates $273 million per year in medical care savings if extensive dental services were offered in the 28 state Medicaid programs where they are restrictive.

“Oral health is the top unmet health need,” said Marko Vujicic, PhD, chief economist and vice president at the ADA Health Policy Institute (HPI). “When low-income adults have access to dental coverage, their employability prospects improve. There’s less spending for chronic health conditions when oral health is maintained. Until we ensure low-income adults have dental coverage, we’re paying an economic penalty.”

Additionally, increased access to dental care for Medicaid adult enrollees can significantly reduce costly emergency department (ED) visits for dental conditions. Dental-related ED visits nationwide cost an estimated $2.1 billion per year, but nearly 79% of those visits could’ve been addressed in a dental office, saving up to $1.7 billion per year.

“It is vital for Congress to understand and acknowledge the critical need to reassess our dental care delivery system to ensure that everyone is able to get the care they need,” said Colin Reusch, senior advisor of oral health policy at Community Catalyst. “We’re asking lawmakers to consider comprehensive and long-term policy solutions that eliminate inequitable barriers to oral health for adults across the country.”

Support for extensive dental coverage for Medicaid-enrolled adults come from across the dental industry including providers, consumer advocates, dental plans, dental service organizations, dental practices, payors, dental supply manufacturers, state dental boards, community clinics, the public health community, government, academia, and philanthropy. The organizations include:

• American Dental Association
• American Dental Hygienists’ Association
• Association of State and Territorial Dental Directors (ASTDD)
• CareQuest Institute for Oral Health
• Community Catalyst
• Dental Trade Alliance
• Diverse Dental Society
• Families USA
• Henry Schein Cares Foundation
• Hispanic Dental Association
• National Association of Dental Plans
• National Dental Association
• National Rural Health Association
• Oral Health Progress and Equity Network (OPEN)
• Overjet, Inc.
• Project Accessible Oral Health
• Santa Fe Group
• The California Pan-Ethnic Health Network

About CareQuest Institute for Oral Health®

CareQuest Institute for Oral Health® is a national nonprofit championing a more equitable future where every person can reach their full potential through excellent health. We do this through our work in grantmaking, research, health improvement programs, policy and advocacy, and education as well as our leadership in dental benefits and innovation advancements. We collaborate with thought leaders, health care providers, patients, and local, state, and federal stakeholders, to accelerate oral health care transformation and create a system designed for everyone. To learn more, visit carequest.org and follow us on Twitter, LinkedIn, Facebook, and Instagram.

About the Oral Health Response Workgroup

The Oral Health Response Workgroup (formerly the Oral Health Pandemic Response Workgroup) is an ad hoc gathering of executives across the dental landscape representing providers, dental plans, dental service organizations, dental practices, payers, dental supply manufacturers, state dental boards, community clinics, the public health community, government, academia, philanthropy, advocates, and members of the community. The group was originally formed in April of 2020 to address critical issues related to oral health created by the pandemic but is now also addressing the broader role of oral health providers and stakeholders in overall health care, including medical-dental care integration.