There’s recent, and largely unheralded, activity in the Biden administration, together with the Department of Health and Human Services (HHS)’s Centers for Medicare & Medicaid Services (CMS), that could make dental care affordable for millions more Americans.
The administration rolled out the Affordable Care Act Marketplaces 2024 on April 2. There are many advantages to the move, but of great interest to dental professionals is the portion that will increase access to routine adult dental services.
In addition, on May 17, Sen. Bernie Sanders of Vermont continued his longstanding and well-known support of access to dental care by introducing the Comprehensive Dental Care Reform Act of 2024. The extensive act would expand Medicaid, Medicare, and Veterans’ Administration to cover dental coverage for veterans, seniors, and low-income families.
While these acts will take months, and possibly years, to have an effect on dental practices, it’s something dental professionals should be aware of, and hopefully welcome when it comes to better oral and overall health for the nation.
Sen. Sanders says he “introduced the most comprehensive dental care bill in the history of our country” because “dental care is health care and health care must be considered a human right, not a privilege.”
There’s no more arguing that ignored dental problems cost the US millions of dollars every year, not to mention the cost to companies that have absent workers, and schools that have absent students due to dental issues. To address these problems, the Comprehensive Dental Care Reform Act would increase the number of dentists, dental hygienists, and dental therapists in underserved areas, making care available in more venues, such as nursing homes, mobile units, and schools.
In the Biden Administration, Health and Human Services secretary Xavier Becerra said the ACA Marketplaces 2024 “rule will allow coverage of routine dental benefits for the first time.”
According to a recent article in USA Today, “Nearly 69 million US adults did not have dental insurance or access to routine oral health care last year, according to a survey by CareQuest Institute for Oral Health. Millions more lost dental insurance last year when states began to unwind Medicaid coverage for people who signed up during the pandemic.”
As it stands now, millions of Americans struggle to find a dentist who will treat their oral condition, which, if left untreated in some cases, can become life-threatening. According to the USA Today article, only one in three dentists agree to take care of Medicaid patients. Even fewer dentists see a lot of Medicaid patients.
The new rule under the ACA Marketplaces 2024 will increase access to adult dental services, create more consistent nationwide standards on how far and how long a consumer must travel to see various types of providers, and make it easier to enroll in coverage.
“Under Biden's rule, states have until 2025 to decide whether to mandate that insurers cover dental benefits for adults. The dental benefits would not take effect until 2027. No states have publicly signaled yet that they intend to require ACA dental benefits in 2027, however, advocates say the new rule could represent a significant expansion of dental insurance, which gets less scrutiny than medical insurance for hospital, doctor and pharmacy bills,” according to the USA Today article.
For more information about the Final Rule, visit HHS Notice of Benefit and Payment Parameters for 2025 Final Rule.
