by Lynn Doan, Strategic Engagement Fellow
Oral health affects everyone and increasing evidence shows that oral health has a significant impact on other areas of physical health. That is why over 800 attendees met at the National Oral Health Conference (NOHC) in Kansas City this past week. The conference highlighted important opportunities to leverage the Affordable Care Act (ACA) from academic, advocacy, and grassroots perspectives.
The ACA brings significant changes to the health insurance landscape, including dental insurance. Now, pediatric dental benefits are one of the ten essential health benefits (the core package of items and services) that all small group and individual market health plans are required to cover. By including pediatric services and dental services as part of the essential health provision, the ACA guarantees dental coverage for children in Medicaid and the Children’s Health Insurance Program (CHIP).
Although the ACA considers dental care essential for children, it does not address basic dental benefits for adults. In Colorado, adults on Medicaid have comprehensive dental benefits; however, most states have chosen to provide only limited or no dental benefits to Medicaid adults. Marko Vujicic, an economist for the Health Policy Institute at the American Dental Association, emphasized access to dental care for adults is especially important since there has been a downward trend of adults actually using their coverage. Going forward, policy makers should consider expanding the ten essential health benefit categories to include adult dental and increase coverage for adults.
Burton Edelstein, a Professor of Dentistry and Health Policy at Columbia University, touched on the impacts of the ACA beyond simple dental coverage and the opportunity to raise the profile of dental care. Because the ACA has shown changes in organization of the health care system, it presents a unique time to reexamine where dentists fit in this new system. For example, dental care is currently separate from primary care visits. However, since dental care for children is now an essential health benefit, there are some opportunities to better coordinate dental and medical care within the pediatric population.
The opportunity to increase access to dental care through collaboration and integration under the ACA was also highlighted by other speakers. Evelyn Lucas-Perry from the American Dental Education Association Policy Center spoke on funding increases for interprofessional education programs under the ACA. Interprofessional training allows different health professionals, such as pediatricians, nurse practitioners, and dentists, to collaborate and create a more holistic approach to dental care. Furthermore, Kim Sibilsky, CEO at Michigan Primary Care Association, believes that the ACA has given us new tools to integrate dental services and create a more comprehensive system, so that there will be no more “you” and “me” among providers, but “us.”
The new health care landscape gives advocates more opportunities to put teeth into health reform through expanded coverage, system redesign, interprofessional education, and comprehensive primary care. Colorado has made great strides towards achieving optimal oral health care, but there is more we can do to keep us moving in the right direction. CCHI hopes to take these national insights from The National Oral Health Conference and apply it through our vision for all Coloradans to access affordable, high quality, and equitable health care.