Efforts pick up steam to expand Medicaid dental benefits for older adults

Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health and the author of "Teeth: The Story of Beauty, Inequality, and the Struggle for Oral Health in America." She can be reached at mary@healthjournalism.org.

Photo: Garry Knight via Flickr

In a recent story for the Baltimore Sun, reporter Andrea K. McDaniels explored a dilemma getting increasing attention these days – the shortage of affordable and accessible oral health services for the nation’s seniors.

“Jocelyn Chapman’s 86-year-old mother needed major dental work, and her family was trying to figure out how to pay for it,” the story began. The search to find a provider for elderly Arletha Chapman was complicated, in large part because Medicare, which covers 55 million retired and disabled Americans, has never covered routine dental benefits.

Medicaid dental benefits for adults vary from state to state: for example, Maryland’s Medicaid program offers no help with adults’ basic dental needs. Only 12 percent of older Americans have some form of dental insurance and fewer than half visited a dentist in the previous year, according to a 2016 study from the Johns Hopkins Bloomberg School of Public Health.

As a result, many suffer the consequences of untreated disease, which can include oral pain, tooth loss, poor nutrition, medical complications and costly emergency room visits.

The problem becomes more pressing as baby boomers age, so oral health advocates are pushing for reform.

In Maryland, grassroots and oral health groups are hopeful that legislation passed this year by state’s General Assembly could lead to an expanded Medicaid dental benefit, McDaniels reported in her story for the Sun.

Meanwhile, nationally, advocates are renewing a call to add dental benefits to Medicare. “Inclusion of a dental benefit in Medicare communicates that oral health is integral to health, not elective,” wrote authors of a recent editorial in the American Journal of Public Health. It was part of a June special supplement devoted to oral health inequities.

“Older Americans need dental homes to receive appropriate dental care and maintain health,” noted the writers, who are scholars affiliated with the Santa Fe Group, a not-for-profit think tank focused on improving oral health.

Removal of the dental exclusion in Medicare would pave the way for inclusion of dental care in Medicare Part B, open the door to dental homes for seniors, and promote the integration of oral health care with the rest of the health care system,” they added.

In the meantime, the search for care goes on. As McDaniels wrote in her story, Jocelyn Chapman finally managed to find dental services for her mother at the University of Maryland School of Dentistry, where geriatric patients can get discount services.

“Clinic staff pulled five of Chapman’s teeth and are fitting her for dentures,” McDaniels reported. “The clinic charged about half the $3,000 that private dentists had quoted, and allowed her to go on a payment plan.”

“’It would have cost us a fortune otherwise,’” Jocelyn Chapman told the Sun.

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