Part of the Conversation
Healthcare reform could be boon for dental care
As members of Congress and the public debated the merits of healthcare reform at press time, those in the dental industry were biting their nails over what might emerge. Bottom line? Healthcare reform might make dental care available to more people. But it also could impose financial burdens on suppliers of dental products and equipment.
"DTA supports a healthcare insurance program that offers dental insurance to its customers," said Fred Freedman, director of marketing for the Dental Trade Alliance. "Oral health is part of systemic health, and dental should be included."
That said, DTA was concerned about a couple of provisions under discussion at press time. One was a proposed 10-year, $40 billion tax on medical device manufacturers. (Dental products are considered medical devices, though not all would be subject to the tax.) A second option being discussed was a 2.5 percent tax on end users of medical devices.
"On the whole, DTA opposes new taxes, whether they are new taxes [on] employer-based healthcare, or a tax on manufacturers of [Class] II and III medical devices," said Freedman. (Class II and Class III refer to those devices considered by the Food and Drug Administration to
present the greatest potential risk to people, and hence, are subject to greater oversight.)
Meanwhile, some practitioners were worried about a proposed $2,000 cap on flexible spending accounts. FSAs are tax-advantaged accounts for use in paying for qualifying medical expenses, including dental care. "FSAs encourage individual responsibility and allow consumers to take an active role in managing health-related expenses," said AAO President Robert Bray, DDS, MS, in a statement. "They should be viewed not as part of the problem, but as part of the solution."
Children’s dental care
Advocates for children’s dental care were heartened by proposals circulating around Capitol Hill at press time. Expansion of pediatric benefits had already been implemented in the law signed in February 2009 reauthorizing and expanding the State Children’s Insurance Health Program, or SCHIP. But pediatric care was an important part of virtually all the healthcare reform proposals under discussion at press time.
For example, most of those proposals called for pediatric care to be included in the so-called health insurance exchange, which was the term being given to the proposed marketplace of competing insurance plans. Industry observers fretted over initial proposals that pediatric dental care would have to come from insurance plans that also offer medical insurance. But as of press time, many of those provisions had been amended, so that stand-alone dental plans would be able to cover care as well.
"We’re very encouraged that all the bills include a pediatric dental benefit" in both the health insurance exchange and the so-called "public option" under discussion, said Danielle Grote Erbele, senior policy analyst, Children’s Dental Health Project. "That’s the result of many, many years of advocacy on behalf of children’s oral health."
Erbele was also encouraged that the bills making their way through Congress would expand Medicaid, making dental care available to more adults.
Of particular importance to CDHP was the fact that the House bill introduced in late October called for oral health experts to sit on health benefits advisory committees, which would be charged with recommending covered benefits. "That’s incredibly important," says Erbele. "Oftentimes, when new programs are created, there is no oral health expertise at the table. So now we’re basically guaranteed that someone who understands oral health will have a seat at the table."
There were some clouds on the horizon, however, at least from CDHP’s perspective. For example, none of the proposals under consideration guaranteed dental care for pregnant women. "There is a huge [connection] between maternal and infant oral health," said Erbele.
CDHP was also concerned about proposals to impose a tax on employer-provided dental care. "Our concern ...is that a burdensome tax on insurance benefits could have the unintended consequence of discouraging people from taking on dental insurance," said Erbele. That said, some observers believed that people would find a way to pay for dental insurance regardless of any tax that would be imposed on it, she added. "But we err on the side of caution, and we’re very concerned about any possible outcome that could result in children not having access to dental care. And we’ve made that position clear to Capitol Hill."
When all is said and done, however, healthcare reform could be very good for Americans. "I’m extremely encouraged by the extent to which dental care is part of the conversation," said Erbele. "I remember a time when people just weren’t talking about it. In many ways, it was not at the forefront. But I think we’ve come very far, when you look at these bills. There’s a growing consensus that this is a public health issue. People on the Hill have gotten that message, and they’re communicating that they want to do something about it."
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