Half a loaf? Low-income seniors only get one thin slice of Medicare dental benefit 

There’s a saying “half a loaf is better than none.” Under Congress’s current Medicare dental benefit proposal, low-income seniors don’t get half a loaf; they barely get a slice.

If you think of the proposed dental benefit in simple terms—as a loaf of bread—Congress is trying to slice it so it feeds all Medicare-eligible seniors. The problem is that each slice is so thin that everyone goes hungry. Middle or high-income seniors have the means to buy extra bread (dental benefits), but what about low-income seniors? For them, that thin slice of bread is all they have.

I applaud Congress for recognizing that oral health is integral to overall health. Now is the time for them to consider who needs a dental Medicare benefit the most.

By and large, thanks to good oral hygiene, a healthy diet, avoidance of tobacco products and regular dental visits, Americans’ oral health has greatly improved over the decades. Yet for low-income seniors who may rarely see a dentist, it is a far different story. According to the American Dental Association’s Health Policy Institute, 26 percent of Medicare beneficiaries do not seek dental care because they cannot afford it. Over time, a lack of care can result in multiple oral health problems which can also greatly impact overall health.

As a dentist and a physician, I see firsthand the tragic consequences of severe dental disease—people in severe pain seeking dental care in hospital emergency departments, people unable to have organ transplant surgery because the infection in their mouths can spread throughout their bodies, and people who have lost all of their natural teeth. These are just a few examples.

That is why the American Dental Association believes policymakers should provide a comprehensive dental benefit to nearly half of all Medicare-eligible seniors—those with incomes of approximately $38,000 each (up to 300 percent of the federal poverty level). 

Comprehensive Medicare dental coverage means providing low-income seniors with a full range of affordable dental services they need to have a healthy mouth…to get them out of chronic pain and be able to comfortably eat and sleep.

Concentrating Medicare benefits on low-income seniors will help improve health equity. Approximately 67 percent of Hispanic seniors and 70 percent of Black seniors have incomes below 300 percent of the federal poverty level. Achieving health equity is a goal of the Biden administration according to HHS Secretary Xavier Becerra.

Why not provide a dental benefit to all Medicare beneficiaries?  For one good reason:

The current House bill does not help those who need it the most, and that is a tragically missed opportunity. The proposed dental benefit in the House bill imposes high patient co-pays. That thin slice of dental benefit bread gets even thinner. For low-income seniors, who often must choose between food and housing, the high Medicare co-pays for major dental procedures will make access to dental care unattainable. 

Congress has a simple choice. Provide a meager dental benefit to all Medicare patients, rich and poor alike, or provide low-income seniors with a comprehensive affordable dental benefit that will significantly help those in need.   

Let’s hope that Congress makes the right choice. 

Daniel J. Klemmedson, D.D.S., M.D., of Tucson, Ariz., is the 157th president of the American Dental Association (ADA). Dr. Klemmedson is a fellow of the American Board of Oral and Maxillofacial Surgery, as well as a member of the Academy of Dentistry International, American Cleft Palate-Craniofacial Association and American Medical Association.