As Congress considers expanding Medicare to include dental benefits as part of the fiscal year 2022 federal budget, the American Dental Association is advocating for a distinct program that would provide comprehensive dental care to low-income older adults.
"We hope that an innovative approach that is adequately funded and efficiently administered and utilizes private, non-profit and government solutions will provide a workable solution and offer opportunities for improved oral health for those whose care is most critical - low income seniors," ADA President Daniel J. Klemmedson, D.D.S., M.D., said in an Aug. 12 letter to Congress.
Little is known about the Medicare dental benefit provision included in the U.S. Senate's approved budget resolution, except that it would cover all Medicare beneficiaries, be included in Medicare Part B and cost an estimated $238 billion over 10 years.
In his letter, Dr. Klemmedson said an expansion of Medicare benefits should include a comprehensive dental benefit that meets the needs of beneficiaries whose income is up to 300% of the federal poverty level. Estimates from the Kaiser Family Foundation show this would cover about 47% of the older adult population.
"This would provide meaningful coverage to most seniors who presently do not visit a dentist because they cannot afford it," Dr. Klemmedson said.
The percent of Medicare-eligible seniors who experienced increased cost barriers to dental care rose between 2009 and 2019. Seniors with incomes at or below 133% of the federal poverty level saw the largest increase in cost barriers, from 10% in 2009 to 26% in 2019, according to the ADA Health Policy Institute.
A dental benefit under Medicare also merits a designated program that recognizes the differences in the delivery of oral health care compared with other health care services, Dr. Klemmedson said. The current Medicare program includes distinct "parts" that acknowledge the variability in the delivery of hospital care, physician services and prescription drugs.
"The ADA believes that any expansion of Medicare to include dental should be through a separate new program dedicated to providing comprehensive dental care for low income seniors - not the Medicare Part B program that has been part of past and current proposals," he said.
The letter aligns with a policy on financing oral health care for adults aged 65 and older that was passed by the ADA House of Delegates in October 2020. ADA lobbyists have been meeting with congressional staff for the past few months to discuss the Association's policy position.
"We look forward to continuing this important conversation with you and your staff as Congress considers how best to provide oral health care to our Nation's seniors," Dr. Klemmedson said.