It’s become a perennial issue in Maine: Lawmakers introduce legislation to extend health insurance, both public and private, to cover dental care. This year is no different with three such bills pending in Augusta.
Two of the bills, including bipartisan legislation sponsored by House Speaker Ryan Fecteau, would add preventive, diagnostic and restorative dental services to the state’s health plan for low-income residents called MaineCare.
Another bill, one of two sponsored by Rep. Heidi Brooks, a doctor, would require health insurance carriers to provide coverage for comprehensive dental services.
This should be the year that lawmakers actually take action, rather than studying the issue or putting it off for a future legislative session.
Fecteau noted the many benefits of extending dental care benefits to more Mainers, including improving their health and mental and economic wellbeing. Expanding access to dental care through MaineCare can also reduce health care costs and lessen racial disparities in care, he told the Bangor Daily News in an interview.
In 2019, Maine lawmakers voted to extend dental coverage to an estimated 70,000 low-income Mainers. However, the bill was not funded in the final days of the Legislature that year.
The bill was changed to create a group to develop an adult dental plan in the MaineCare system. The amended bill was carried over to 2020 but died when the Legislature abruptly adjourned last March at the start of the coronavirus pandemic.
Now, lawmakers have another chance to pass and fund this important change. They should take it.
Federal law requires that state Medicaid plans cover pediatric, preventive dental care — but no such requirement extends to coverage for adults.
That leaves adult dental coverage options inconsistent and dependent on a mix of state policy decisions and state-by-state insurer offerings. In Maine, adults with Medicaid can receive coverage only for dental emergencies, such as tooth extractions, which are generally needed only after manageable dental problems have developed into major — and expensive — health issues.
Maine is one of 12 states with public health plans that only cover dental emergencies. Thirty-four states offer more extensive coverage and four offer none.
Simply put, dental care is health care. Study after study has demonstrated the long-term health benefits of regular dental visits. Routine dental care can prevent the need for more serious and more expensive procedures in the future.
A 2010 study of emergency room use by the Muskie School of Public Service at the University of Southern Maine revealed that dental disease was the top reason for someone ages 15 to 44 with MaineCare or without insurance to seek emergency room care.
Researchers have found that adequate, preventive dental care is linked with fewer hospital admissions, and substantially lower medical costs during pregnancy and to treat type 2 diabetes, coronary artery disease and cerebrovascular disease. Preventive dental care, once integrated into the health insurance system, is a benefit that can go a long way toward paying for itself.
Dental care is also about economic viability. In a 2015 survey by the American Dental Association and Health Policy Institute, nearly half of the low-income respondents in Maine said their teeth and mouth were in only fair or poor conditions. Thirty-seven percent of low-income Maine survey participants said the condition of their teeth affects their ability to interview for a job. A third of Maine adults said they avoid smiling because of the poor condition of their teeth.
For these reasons, including dental care in comprehensive health insurance is long overdue.
