2021 Medicare dental benefit expansion falls short — a timeline

A legislative attempt to expand dental coverage for Medicare recipients was stalled in October when a new version of Congress' reconciliation package left out the expanded benefit.

The bill, introduced in July, would have expanded limited dental care for the 62.7 million people who receive Medicare. The proposal received mixed reaction from dental professionals before the expansion eventually was taken off the table.

A timeline of events:

July

Senate Democrats introduce the $3.5 reconciliation bill that would cover dental, vision and hearing for Medicare recipients.

August

A group of healthcare organizations and experts sends a letter to Congress Aug. 3 asking for strengthened dental coverage under Medicare to reduce healthcare inequities and long-term healthcare costs. In it, the organizations ask Congress to pay for Medicare expansions through drug price negotiations. The letter also includes results from a Morning Consult poll that found the majority of Americans support adding dental, vision and hearing coverage to Medicare.

On Aug. 12, American Dental Association President Daniel Klemmedson, DDS, MD, sends a letter to Congress advocating for a separate program dedicated to providing dental coverage to low-income Medicare seniors.

September

CMS projects that implementation of expanded dental benefits under Medicare would take three to five years, pushing federal officials to try and accelerate adoption of the reconciliation package in the fall. Senate Democrats consider two options to provide a financial benefit to seniors while the plan is implemented, including working with private dental companies and establishing a temporary program that would send funds to seniors. They later introduce a proposal that would delay the addition of dental benefits until 2028.

The ADA asks dentists Sept. 8 to contact members of Congress to oppose dental benefits being considered under the reconciliation package, stating that it does not consider the difference between physician offices and dental offices, would not properly reimburse dentists, and includes administrative, technical and programmatic requirements that would not best serve older patients.

October

The National Dental Association voices its support for expanded Medicare dental benefits, stating that the reconciliation package would improve oral health equity by removing the financial barrier to oral care for elderly people and people with disabilities. It lists several provisions to strengthen the bill before passage, including a comprehensive dental benefit not limited to preventive services, a reimbursement model that would encourage provider participation, implementation of benefits as soon as possible after passage and multiple administrative processes to prevent barriers to provider participation.

The American Dental Education Association releases a statement supporting the bill, citing a 2020 federal report that found dental care was most frequently skipped by Americans due to their inability to pay.

October ends with the White House's failure to include expanded dental benefits under the federal program. The bill reportedly is scaled back to only include expanded hearing benefits
as President Joe Biden seeks to gain broader support for the spending package. The CareQuest Institute for Oral Health calls the cut a "huge disappointment" Oct. 28.

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