USA - Bill Would Mandate Dental Coverage for Children
Bill Would Mandate Dental Coverage for Children in State Programs
By: Andrew Glass
April 9, 2007 05:28 PM EST
Responding to the recent preventable deaths of children in Maryland and Mississippi from untreated dental infections, Congress is moving toward including mandatory dental coverage for children in state-subsidized health programs.
The legislation is on track to be folded into the biannual reauthorization of the State Children's Health Insurance Program, known as SCHIP, which the House is due to consider later this month.
"Lack of dental care is the most prevalent unmet health need among our children," said Rep. Mike Simpson (R-Idaho), who left his dental practice when he entered the House a decade ago. "Tooth decay and other dental diseases often lead to other, more severe health-related issues in children."
"You could even say it is at the 'root' of the problem," he added.
There are strong indications that the bipartisan legislation will be adopted by the Democratic-led House. The prospects markedly improved when Rep. John Dingell (D-Mich.) last week formally joined Simpson, a member of the House Appropriations Committee, as a chief co-sponsor of the Children's Dental Health Improvement Act of 2007. Dingell chairs the House Committee on Energy and Commerce, whose subcommittee on health has become deeply involved in the dental coverage issue.
"Today, 4 (million) to 5 million children in America suffer from dental disease that limits their ability to eat, sleep, play and learn," Dingell said, noting that more than 850,000 school days are missed each year by children with dental problems.
The bill also creates several grant-based programs aimed at improving the delivery of pediatric dental services, raising oral health awareness and highlighting the need for preventive care at the state level. States also gain the option of wrapping government-subsidized dental services into minimal corporate or private plans that often do not offer such extended services.
Low-income children who have a preventive dental visit by age 1 are less likely to require subsequent restorative or emergency room visits, and their average dental-related costs are nearly 40 percent lower over five years. Lawmakers and lobbyists who back the initiative say the legislation would save federal funds by placing a greater emphasis on preventive care.
"Dental disease is the most common childhood disease -- more prevalent than asthma, diabetes and hay fever. It is also the easiest to prevent," Dingell said. "The recent deaths of two young children -- in Maryland and Mississippi -- have refocused our attention to the importance of early access to dental care. These tragedies have also made it clear that stronger federal oversight is needed."
Deamonte Driver, 12, died in late February, when a sore tooth progressed into a fatal brain tumor. His mother, Alyce, had held several low-paying jobs in Prince George's County. None of them, however, provided health insurance. Deamonte's tooth abscess eventually spread to his brain. Before he died, he spent six weeks at Children's Hospital in Washington after having undergone emergency brain surgery. One of his doctors said if his bad tooth had been treated in a timely way, the brain disease could have been easily avoided.
Less is known about a similar case that occurred about the same time in Harrison County, Miss. The death of 6-year-old Alexander "Alex" Callender from a brain infection is still under review by the county coroner.
In the Senate, a similar bill was introduced last month by Sen. Jeff Bingaman (D-N.M.) and has attracted about a half-dozen co-sponsors. Bingaman has sought to expand dental coverage since 1999. But this year, with Democrats in charge of both the House and the Senate, the chances look better.
There are broader issues, however, that some dentists say the new legislation only partly addresses. A key issue is the reluctance of many dentists to participate in the Medicaid program because the reimbursements are set too low. Moreover, relatively few dentists choose to practice in low-income and rural areas, where the need for Medicaid services is most acute.
About half of all Medicaid users are poor children. And it is the federal government's largest health care program in terms of enrollment. At the same time, the Congressional Budget Office reports that as many as a third of the 10 million children who are eligible for coverage fail to enroll in the program.
All 50 states currently include dental coverage in their SCHIP programs. But, from time to time, some of them have dropped it. If adopted, the new legislation would lock in such states as Texas, which has gone back and forth on offering subsidized treatment.
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by winston smith on 04.10.2007 at 01:59 AM
Wow.... I am very surprised that there are no rabid repubs complaining about how libs go all soft and want to socialize the good ol' USofA just because two poor kids died.
Of course they would prefer to deny that there is a real problem in the first place.....this article makes that kinda hard. But give them time. The anti-socialist/communist rants are coming.
If they are really creative they may just be able to mix in how turning your back on poor sick kids in no way makes you less of a Christian.
REPORT ABUSE
by nyscof on 04.09.2007 at 09:06 PM
Dentists truly believe that freedom of choice is to be waived when considering the best interests of the poor. That's what they tell us when they advocate fluoridation legislation. So they shouldn't be upset when they are legislated to be required to treat a certain number of low-income Americans either for free or for what Medicaid and/or state funded insurance pays. Since their dental schools and/or dental education is government subsidized, dentists must be required to "give back."
Another solution is Dental Health Aide Therapists (DHATs) who have worked for decades in other countries, such as Canada and New Zealand, just as effectively but more cheaply than dentists. The first one is working in rural Alaska where dentists refuse to go.
Whoops, the American Dental Association wants it stopped. They are suing to have the Alaskan DHAT program ended. It seems the ADA would prefer that, if dentists don't want to treat a subset of the population, no one else should be allowed to either.
It's not lack of insurance so much as the problem is lack of dentists who will treat people with publicly sponsored insurance that, traditionally, pays much less than dentists can extract from their wealthier patients.
Any solution that doesn't involve more money given to dentists usually is not embraced by organized dentistry - whose members often make more money than physicians while working fewer days and fewer hours - treating the 80% of America that has the least tooth decay.
By: Andrew Glass
April 9, 2007 05:28 PM EST
Responding to the recent preventable deaths of children in Maryland and Mississippi from untreated dental infections, Congress is moving toward including mandatory dental coverage for children in state-subsidized health programs.
The legislation is on track to be folded into the biannual reauthorization of the State Children's Health Insurance Program, known as SCHIP, which the House is due to consider later this month.
"Lack of dental care is the most prevalent unmet health need among our children," said Rep. Mike Simpson (R-Idaho), who left his dental practice when he entered the House a decade ago. "Tooth decay and other dental diseases often lead to other, more severe health-related issues in children."
"You could even say it is at the 'root' of the problem," he added.
There are strong indications that the bipartisan legislation will be adopted by the Democratic-led House. The prospects markedly improved when Rep. John Dingell (D-Mich.) last week formally joined Simpson, a member of the House Appropriations Committee, as a chief co-sponsor of the Children's Dental Health Improvement Act of 2007. Dingell chairs the House Committee on Energy and Commerce, whose subcommittee on health has become deeply involved in the dental coverage issue.
"Today, 4 (million) to 5 million children in America suffer from dental disease that limits their ability to eat, sleep, play and learn," Dingell said, noting that more than 850,000 school days are missed each year by children with dental problems.
The bill also creates several grant-based programs aimed at improving the delivery of pediatric dental services, raising oral health awareness and highlighting the need for preventive care at the state level. States also gain the option of wrapping government-subsidized dental services into minimal corporate or private plans that often do not offer such extended services.
Low-income children who have a preventive dental visit by age 1 are less likely to require subsequent restorative or emergency room visits, and their average dental-related costs are nearly 40 percent lower over five years. Lawmakers and lobbyists who back the initiative say the legislation would save federal funds by placing a greater emphasis on preventive care.
"Dental disease is the most common childhood disease -- more prevalent than asthma, diabetes and hay fever. It is also the easiest to prevent," Dingell said. "The recent deaths of two young children -- in Maryland and Mississippi -- have refocused our attention to the importance of early access to dental care. These tragedies have also made it clear that stronger federal oversight is needed."
Deamonte Driver, 12, died in late February, when a sore tooth progressed into a fatal brain tumor. His mother, Alyce, had held several low-paying jobs in Prince George's County. None of them, however, provided health insurance. Deamonte's tooth abscess eventually spread to his brain. Before he died, he spent six weeks at Children's Hospital in Washington after having undergone emergency brain surgery. One of his doctors said if his bad tooth had been treated in a timely way, the brain disease could have been easily avoided.
Less is known about a similar case that occurred about the same time in Harrison County, Miss. The death of 6-year-old Alexander "Alex" Callender from a brain infection is still under review by the county coroner.
In the Senate, a similar bill was introduced last month by Sen. Jeff Bingaman (D-N.M.) and has attracted about a half-dozen co-sponsors. Bingaman has sought to expand dental coverage since 1999. But this year, with Democrats in charge of both the House and the Senate, the chances look better.
There are broader issues, however, that some dentists say the new legislation only partly addresses. A key issue is the reluctance of many dentists to participate in the Medicaid program because the reimbursements are set too low. Moreover, relatively few dentists choose to practice in low-income and rural areas, where the need for Medicaid services is most acute.
About half of all Medicaid users are poor children. And it is the federal government's largest health care program in terms of enrollment. At the same time, the Congressional Budget Office reports that as many as a third of the 10 million children who are eligible for coverage fail to enroll in the program.
All 50 states currently include dental coverage in their SCHIP programs. But, from time to time, some of them have dropped it. If adopted, the new legislation would lock in such states as Texas, which has gone back and forth on offering subsidized treatment.
Join The Conversation
You need to be a registered user of Politico.com to "join the conversation". If you are not a member yet, what are you waiting for? Register Now!
by winston smith on 04.10.2007 at 01:59 AM
Wow.... I am very surprised that there are no rabid repubs complaining about how libs go all soft and want to socialize the good ol' USofA just because two poor kids died.
Of course they would prefer to deny that there is a real problem in the first place.....this article makes that kinda hard. But give them time. The anti-socialist/communist rants are coming.
If they are really creative they may just be able to mix in how turning your back on poor sick kids in no way makes you less of a Christian.
REPORT ABUSE
by nyscof on 04.09.2007 at 09:06 PM
Dentists truly believe that freedom of choice is to be waived when considering the best interests of the poor. That's what they tell us when they advocate fluoridation legislation. So they shouldn't be upset when they are legislated to be required to treat a certain number of low-income Americans either for free or for what Medicaid and/or state funded insurance pays. Since their dental schools and/or dental education is government subsidized, dentists must be required to "give back."
Another solution is Dental Health Aide Therapists (DHATs) who have worked for decades in other countries, such as Canada and New Zealand, just as effectively but more cheaply than dentists. The first one is working in rural Alaska where dentists refuse to go.
Whoops, the American Dental Association wants it stopped. They are suing to have the Alaskan DHAT program ended. It seems the ADA would prefer that, if dentists don't want to treat a subset of the population, no one else should be allowed to either.
It's not lack of insurance so much as the problem is lack of dentists who will treat people with publicly sponsored insurance that, traditionally, pays much less than dentists can extract from their wealthier patients.
Any solution that doesn't involve more money given to dentists usually is not embraced by organized dentistry - whose members often make more money than physicians while working fewer days and fewer hours - treating the 80% of America that has the least tooth decay.
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9:55 AM
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