For seniors’ dental care, Medicare needs to step up

Strengthening Medicare by adding dental benefits could help more than 4.5 million people in California; the largest number of Medicare beneficiaries of any state

A 72-year-old woman went in for surgery to remove a brain tumor in 2019. The last thing she remembers before her surgery was a doctor putting her to sleep. When she awoke, she was missing her dentures, her glasses, and had no memory of how she got home.

Shortly after, the COVID-19 pandemic hit, and for a year thereafter she had no teeth or glasses.

Poor oral health is directly linked to conditions such as diabetes, heart disease, respiratory illness, and even Alzheimer’s

Most seniors are surprised to learn that when they retire and begin to rely on Medicare for their health coverage, they are left without oral health care. In fact, of the 60 million Medicare beneficiaries, more than two-thirds don’t have any dental coverage at all. Medicare doesn’t cover vision or hearing health services either.

Nearly half of all Medicare patients haven’t visited a dentist within the past year. Those numbers are closer to 70% for Black, Hispanic and lower-income Medicare beneficiaries. One in five rural seniors haven’t seen a dentist in the past five years.

Poor health coverage has unsurprisingly led to poor health outcomes. Poor oral health is directly linked to conditions such as diabetes, heart disease, respiratory illness, and even Alzheimer’s — all diseases that particularly impact our older citizens, put them at even greater risk of COVID-19, and worsen racial health disparities.

This is just one example of how gaps in coverage and access to care that have existed for generations were exacerbated during the pandemic, leaving some of the most marginalized populations to bear the brunt of our health crisis.

According to a nationwide survey by CareQuest Institute, 93% of Americans supported the inclusion of dental coverage under Medicare.

As we work to emerge from this pandemic, we cannot ignore these gaps in coverage any longer. Closing gaps in this coverage will not only improve equitable access to quality care, but help save money in the long run. Currently, more than two million people visit emergency rooms each year due to oral health complications, many of whom could have been treated in a preventive, less-expensive primary care setting. One study identified $65 billion in medical savings over ten years simply by providing dental and periodontal treatment through Medicare.

Finally, there is momentum to change the unacceptable status quo for our seniors and people with disabilities. In August, Senate Democrats released a $3.5 trillion budget blueprint that included Medicare dental, vision, and hearing coverage. We expect a formal package to be released as early as this month. In September, the House Ways and Means Committee voted to advance a measure expanding Medicare coverage to include vision, hearing and dental care. President Biden has also proposed including these benefits during his campaign for President.

These policies are overwhelmingly supported by Americans from all demographics, regions, and political parties. According to a nationwide survey by CareQuest Institute, 93% of Americans supported the inclusion of dental coverage under Medicare. In a recent Morning Consult/Politico poll, 84% of voters — 89% of Democrats and 79% of Republicans — favored adding dental, vision and hearing coverage. Similar numbers supported allowing the federal government to negotiate drug prices. The need and support for these benefits to be covered under the Medicare program is crystal clear.

Strengthening Medicare Part B to include dental, vision, and hearing is a no-brainer from a care, access, racial and economic justice perspective. And it’s supported by, well, everyone.

By closing this giant gap in our Medicare system, we’ll finally be building a path to a healthier future for our seniors and all those who have been left behind by a broken health system. This pandemic has presented us with enormous public health challenges, but it has also given us the opportunity to rewrite the book and recover stronger, healthier, and more equitable than ever before.
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Editor’s Note: Dr. Myechia Minter-Jordan, MD, MBA, is the president and CEO of the CareQuest Institute for Oral Health. Kiran Savage Sangwan is executive director of California Pan-Ethnic Health Network (CPEHN).