How the 2024 Dental Reform Bill could transform dental practice and reimbursement

Michigan Congresswoman Debbie Dingell recently introduced a bill designed to expand dental coverage under Medicare, Medicaid, the Affordable Care Act, and the VA. The Comprehensive Dental Care Reform Act of 2024 aims to improve access to dental care in underserved areas by increasing reimbursement rates for dental procedures under Medicaid and prioritizing dental service accessibility in community health centers, schools, nursing homes, and mobile units nationwide.¹

It will cover five main areas aimed at ending the dental crisis in America: coverage (prioritizing reaching disadvantaged populations), access points (providing more places people can go to access a qualified oral health care professional), workforce (increase the number of providers in areas with the greatest need), education (help oral health professionals understand how to better serve vulnerable communities), and research (help fund research on prevention and disease management).²

Why this bill matters

This bill has the potential to change the lives of those who struggle to access dental care. Millions of Americans do not have access to affordable health care, particularly pregnant women, veterans, those who are non-white, low-income, live with disabilities, or are located in a rural community.

Many dental practices find that accepting Medicare and Medicaid is not feasible, however, as the reimbursements tend to be lower than what private insurance provides.

And in terms of dental coverage and accessibility in America:

• Nearly 70 million adults and 8 million children have no dental insurance

• Nearly half of Americans with dental insurance have skipped appointments because they could not afford the necessary dental procedures

• Nearly one out of every five seniors have lost all their natural teeth and cannot afford dentures

• Seventy percent of older Americans have a periodontal disease, which can lead to rheumatoid arthritis and cardiovascular disease1

According to a press release from Dingell's office, Medicare patients with heart disease can also save up to $27.8 billion annually if they receive the dental treatment they need.1 For dental services covered by Medicaid, states can be eligible for an enhanced FMAP (15% increase) if they meet requirements to address provider participation and patient utilization.²

In the same press release, Dingell said: "Too many people don't go to the dentist because of fear, not of the dentist itself, which many admittedly have, but more about the bill they will receive after. A lack of dental care can worsen other serious medical conditions, but without adequate coverage, millions of Americans go without the critical oral care they need."¹

Melissa Burroughs, director of public policy at CareQuest Institute for Oral Health, also believes The Comprehensive Dental Care Reform Act of 2024 will positively impact oral health care accessibility in our country. She said:

"We were excited to see the House introduce the Comprehensive Dental Reform Act, which is significant because we haven't seen a House companion on this bill for nearly 10 years. It also encourages greater provider participation in Medicaid by incentivizing higher reimbursement rates for dental services - a critical provision as we know people on Medicaid often face barriers to care because of the shortage of providers who accept it. Overall, this step forward for oral health builds on some recent momentum we've seen around the issue at the national level and the will of voters who want more of a focus on oral health."

References

1. Dingell introduces bill to expand access to dental care. Debbie Dingell. September 2024. https://debbiedingell.house.gov/news/documentsingle.aspx?DocumentID=5266

2. Comprehensive Dental Reform Act of 2024. Debbie Dingell. September 2024. (https://debbiedingell.house.gov/uploadedfiles/summary-comprehensive-dental-reform-act-of-2024.pdf