May 4, 2021
The Legislature’s Health and Human Services Committee unanimously voted to advance a bill from House Speaker Ryan Fecteau of Biddeford Tuesday. The bill shifts Maine’s reliance on emergency-only dental coverage to a preventative dental care model to improve health outcomes and save the state money over time.
LD 996, An Act To Improve Dental Health Access for Maine Children and Adults with Low Incomes received support from public health experts and economists as a smart investment.
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 were offered.
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% of the impact in rural areas. If LD 996 becomes law, Maine would be eligible for federal matching funds and expanded coverage would go into effect on April 1, 2022.
“This is an issue that impacts every single community in our state. Our system forces vulnerable people to use the emergency room when their teeth have reached the point of no return, which ends up costing Maine people their dignity and health. Ultimately, it also costs our state economically,” said Speaker Ryan Fecteau-D of Biddeford, the lead sponsor of the bill. “Today’s bipartisan vote shows that dental care is a critical issue in all parts of our state.”
“Looking at the downstream benefits from this bill, I see the possibility of those investments that will occur in the short-term leading to significant dividends that will be achieved here in the state of Maine,” said Representative Sawin Millett-R of Waterford, a co-sponsor of the bill. “This is a sequential and methodological approach to implementing an ambitious undertaking. The current law is a last-resort nature and I think that is unfortunate for the human element and our societal commitment. I see this as a positive step. This investment, on the human side of the equation as well as the Maine economic side, will provide benefits that are predictable and that will have a high cost-benefit ratio. That is a choice that all of us in the Legislature, I believe, are willing to make given the investments that lie before us, the options that we have and the resources that we uniquely have at this point in time. I’m pleased to be a co-sponsor of this legislation.”
“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.”
“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.”
“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.”
“Early this year I broke a molar, an significant issue for anybody but this was my last molar on my lower jaw. A long period of pain, anticipation and dread (and worsening mental health) ended with that major chewing surface broken, a new (heart-breakingly familiar) period of anxiety began. Last month, I had that broken molar removed, the 12th extraction I’ve had performed in my adult life. The only reason I could afford that was a GoFundMe (because my insurance at work hadn’t started yet and would only cover a small portion in any case.) Dental care is expensive, most of the jobs I’ve had over the last decade didn’t include comprehensive dental care. Policies that restrict access to dental care meant that I had to learn to live with pain, I had to choose to wait and throw a tooth away because to fix it meant I couldn’t have a car or a place to stay. The feeling I was left with was; because of how much money I had, I didn’t deserve to have functioning teeth,” said Joshua Kauppila of Bangor.
“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.
“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.”
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.