Houston, Texas – The legacy of C. Everett Koop, the former U.S. Surgeon General, extends beyond his renowned work in pediatric surgery and his advocacy during the HIV-AIDS crisis. Koop’s emphasis on the importance of oral health has resurfaced as millions of Americans continue to lack access to basic dental services like checkups and cleanings, even decades after Koop’s tenure in the Reagan administration.
Despite the crucial role that oral health plays in overall well-being, traditional Medicare does not cover routine dental care for its beneficiaries, leaving approximately 24 million seniors without assistance in paying for essential dental services. The absence of dental coverage in Medicare dates back to the program’s inception in 1965, when concerns over cost and provider opposition led to the exclusion of most dental services from coverage.
Efforts to incorporate dental benefits into Medicare have gained momentum in recent years, with the Centers for Medicare and Medicaid Services and other organizations advocating for the inclusion of dental services in the program. The Biden administration aimed to introduce comprehensive dental coverage through its Build Back Better legislation, but faced challenges in garnering congressional support, resulting in the exclusion of dental coverage in the final bill passed by the House in 2021.
Recognizing the critical link between oral health and overall health, the federal government later expanded Medicare to cover medically necessary dental treatment for specific conditions, such as organ transplants and cancer treatment radiation affecting the jaws. However, advocates argue that basic dental services should be accessible to all Medicare beneficiaries, especially older adults who are at higher risk of oral health issues.
Research indicates that inadequate oral health not only leads to dental problems but also contributes to serious medical conditions such as cardiovascular disease, diabetes complications, pneumonia, and even cognitive impairments like Alzheimer’s disease. Despite these findings, disparities in dental care persist among different socioeconomic groups, with low-income individuals facing greater barriers to accessing preventive dental services.
As the debate over dental coverage in Medicare continues, alternative options like Medicare Advantage plans offer some relief by providing limited dental benefits through private insurers. While these plans vary in coverage, many older Americans still struggle to afford necessary dental care, spending significant amounts out of pocket each year. Advocates argue that expanding dental benefits in Medicare could improve the overall health and well-being of older Americans while potentially lowering healthcare costs in the long run.