Group Works to Expand Medicare to Include Dental Coverage

April 12, 2017
Sarah Handzel, BSN, RN

The Santa Fe Group is working to expand Medicare to include dental coverage for Americans aged 65 and older. Currently, Medicare does not offer this benefit. Citing an increasing body of research that links oral health to conditions such as heart disease and diabetes, the nonprofit is hoping to find sympathetic ears for its lobbying efforts in Washington.

Recent research shows that only about 12 percent of Americans over age 65 have dental insurance.

Currently, Medicare does not commonly cover any types of dental benefits for Americans aged 65 or older. According to the Centers for Disease Control and Prevention, almost one in five people in this age group have untreated tooth decay. In an attempt to find coverage solutions that will allow older adults to receive the treatment they need, the Santa Fe Group, a nonprofit think tank, is working toward expanding Medicare coverage to include dental care.

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Research has already shown that untreated tooth decay can lead to or exacerbate a variety of health problems, such as heart disease or diabetes. This in turn creates more treatment costs that Medicare ultimately pays. At present, fewer than half of elderly Americans visit a dentist each year, partially because they cannot afford to. Also, only 12 percent of Americans aged 65 or older have dental insurance.

It might be an uphill climb to enact any sort of change to Medicare benefits related to dental services, especially in the current presidential administration. The number of older Americans who would benefit from such an increase in coverage is expected to grow by at least 30 percent by 2030. In a study by Johns Hopkins, estimated costs for increasing the dental benefit could be anywhere from $4.4 billion to $16.2 billion depending on the coverage offered, out-of-pocket expenditures, and any subsidies provided to low-income beneficiaries.

The Santa Fe Group’s members include professionals from varying backgrounds: academics, dental industry executives, and former government officials. Dr. Claude Fox, a former Clinton administration senior health official, says, “We have a long road to go, but we think it’s doable and there will be a growing audience for this. It is important to show a benefit can be structured to save money for Medicare.”

The Santa Fe Group is promoting the benefits of increasing dental care coverage, in addition to lobbying Congress about elderly American’s problems with pain and eating issues related to tooth decay. The group points to the benefits of increasing coverage, noting that the treatment of tooth decay can stave off more serious issues, like diabetes, that have a greater health impact and cost more.

Additionally, the Santa Fe Group hopes to secure the support of the American Dental Association, the AARP, and other seniors’ groups. The group already has sponsorship from several companies within the dental industry, including Henry Schein and Colgate-Palmolive.

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