ADA vs CBO: Including Dental Coverage Under Medicare

The Congressional Budget Office (CBO) estimated that adding dental, vision, and hearing benefits would increase Medicare’s direct spending, but the American Dental Association (ADA) is claiming reimbursement will not be enough to cover these costs

The American Dental Association (ADA) is fighting against a proposal to include dental coverage for all Medicare recipients, The Wall Street Journal reported.

On September 15, The House Committee on Energy and Commerce advanced provisions of a $3.5-trillion budget reconciliation package, which included a proposal to expand vision benefits under Medicare in 2022, hearing in 2023, and dental in 2028.

Supporters of the bill argue it will provide necessary care to those unable to afford these coverages. However, the ADA said Medicare will not reimburse enough money to cover the costs and is pushing an alternative that would still benefit Medicare recipients with the lowest incomes.

“The ADA is opposed to the Medicare dental provision as proposed in the committee-passed bill, but does support an alternative proposal expanding access to oral health care for low-income seniors,” ADA News reported. “The ADA proposal is in line with ADA policy and includes a range of services necessary to achieve and maintain oral health for beneficiaries with incomes up to 300% of the federal poverty level.”

According to a letter from the Congressional Budget Office (CBO) addressed to the committee, the bill would increase direct spending by about $40 billion and revenues by about $46 billion over the 2020-2029 period. The CBO also estimated that Title VI of the plan—which would add new benefits for dental, vision, and hearing coverage under Medicare such as dentures, glasses, hearing aids, and preventive services—would increase direct spending by about $358 billion in 10 years.

Of that amount, the CBO claims almost $238 billion would go toward dental care; $30 billion, vision care; and $89 billion, hearing services.

In a livestream video of a session, Kurt Schrader (D-OR) mentioned his reservations about adding additional services to Medicare.

"I've got very serious concerns about adding additional programs, services, and costs when Medicare itself is facing insolvency in a mere 5 years. We've sort of forgotten that fact," he said. "Even the Part B program is consuming ever great numbers and amounts of general fund revenue. We can't afford the current benefits right now."

In the CBO letter, he added that the increase in revenues would be primarily due to the availability of lower drug prices, which would reduce the estimated cost of health insurance offered by employers.

The bill has been passed to the House Budget Committee and House Rules Committee and will now go to the House for a full vote. After the House votes, the bill will then move to the Senate.

According to The Wall Street Journal, no Republican members of the Senate are expected to vote for any version of the legislation, and CMS said it is prepared to implement whatever is approved by Congress.

The ADA is currently asking its 162,000 members to contact lawmakers in opposition to the bill.