Maine Insights Newsmagazine

April 30, 2021

By Ramona du Houx

A new piece of legislation that is aimed at expanding access to dental care in Maine is making its way through the legislative process: LD 996, An Act To Improve Dental Health Access for Maine Children and Adults with Low Incomes. The bill received support from public health experts and economists as a smart investment that would improve the health of Maine’s people and save the state money.

“This is an issue that impacts every single community in our state. Our system forces vulnerable people to use the emergency room, which ends up costing Maine people their dignity and health. Ultimately, it also costs our state economically,” said Speaker Ryan Fecteau-D of Biddeford, who introduced the measure.

Because Maine is one of only ten states that provides emergency-only dental treatment through Medicaid, the state pays up to $17 million in avoidable emergency room care annually. Low-income Mainers can only access dental care through Medicaid in emergency situations and likely when they face infections or serious pain, often resulting in more dire and costly health issues that could be avoided if preventative dental care was offered.

If LD 996 passes, Maine would be eligible for federal matching funds.

“In my experience and studies as a Health Care Educator, I know how important it is to have good dental care regardless of one’s economic status,” said Senator Marianne Moore-R of Washington County, a co-sponsor of the bill.  “This bill would help cancer patients I work with and those in Washington County in recovery.”

In 2012, the MaineCare Redesign Task Force convened by then-Commissioner Mayhew concluded that MaineCare provided $17 million in emergency room care that could have been avoided if patients had received preventative dental treatment in the community. A recent study showed the economic impact of LD 996 will be $21.6 million, with nearly 50 percent of impact in rural areas.

“I know from personal experience that when money is tight and you’re struggling to afford basic expenses like rent, heating or food, going to the dentist just isn’t a priority,” said Representative Supica-D of Bangor,  a co-sponsor of the bill. “Dental care is health care. Including dental services under MaineCare will improve the health and quality of life outcomes for low income Mainers across the state.”

The Health and Human Services Committee heard testimony from lawmakers, addiction specialists, mental health providers, dentists, physicians, citizens in recovery, members of Maine’s religious community, impacted Mainers and Maine parents in support of this bill. Here are some of their comments:

“It’s important to note that this problem goes well beyond cavities, pain, oral infections, and lost teeth.  I have seen hundreds of diabetics whose management and control are worsened by chronic dental disease, dental infections so advanced that they have required ICU management for generalized sepsis and airway obstruction, and life-threatening lung infections associated with chronic dental disease,” said Dr. Barbara Covey, an Emergency Department physician who serves on the board of nonprofit Waterville Community Dental Center. “The passage of LD 996 provides a means to improve both the health and economy of our community.  It provides a far better use of our health care dollars than the current emergency-only MaineCare benefit.”

“Oral disease does not discriminate based on age, race, sexuality, or socioeconomic strata. Every one of us is at risk of oral disease, but those who have the least are at highest risk,” said Dr. Wendy Alpaugh, a dentist from Stonington.  “Barriers to dental care are formidable for those without the means to be seen by a dental professional. Leveling the playing field is a win for society.”

“Making sure that parents can access comprehensive dental care is essential to helping kids get the care they need.  It’s time to recognize that oral health is health, and oral health care is not a luxury item but is something that all families in Maine deserve,” said Becca Matusovich, Executive Director of Partnership for Children’s Oral Health.

“The Maine Dental Association strongly believes that a comprehensive adult dental benefit is critical to adequately addressing the oral health needs of all Mainers. We enthusiastically support this important legislation.” said Angela Cole Westhoff, Executive Director of Maine Dental Association.

“This bill is a game changer for oral health equity. Oral health is essential to overall health and well-being and access to care should be available to all Mainers,” said Bryan Wyatt of Maine Primary Care Association.

“As a long-time funder of efforts to improve oral health in Maine, the Bingham Program is a strong supporter of adding a dental benefit to Maine’s Medicaid program.  This insurance coverage will allow many adults in Maine to get the dental care they need for better overall health outcomes, and is a critical step toward significantly improving the health of thousands of Mainers,” said Morgan Hynd, Director of The Bingham Program.

“Dental care is health care. It touches on many aspects of our lives—affecting what we can eat, our employment, chronic conditions like diabetes and heart disease, prenatal health, mental health, and our ability to smile even with our families and loved ones. We know access to comprehensive dental care is vital for our health, it reduces emergency department use, it reduces costs for certain other health conditions, and it increases employability and productivity for workers,” said Kathy Kilrain del Rio, Director of Campaigns & Healthcare Advocacy, Maine Equal Justice. “L.D. 996 would help Maine parents, adults with disabilities, Mainers 65 and older, workers, and adults across our entire state. It’s a smart choice for Mainers’ health, for our MaineCare program, and for our state economy.” 

“It  is critical that Maine people have access to the oral health care they need. LD 996 provides coverage for comprehensive preventive, diagnostic and restorative dental care to Mainers who would likely otherwise go without the services they need,” said Kate Ende, Policy Director, Consumers for Affordable Health Care. “This is a commonsense solution that will help reduce barriers many in Maine face accessing the care they need.”

The public hearing for this bill can be viewed on the Maine’s Health and Human Services Committee YouTube Channel here. This morning’s press conference can be streamed here. This bill will face a vote in the Health and Human Services Committee in the coming weeks.