Mr. President, I rise today to discuss two bills addressing oral health, which I am introducing today. These bills will provide incentives for dental and dental hygiene graduates to remain as dental…
Mr. President, I rise today to discuss two bills addressing oral health, which I am introducing today. These bills will provide incentives for dental and dental hygiene graduates to remain as dental school faculty and make the Children's Health Insurance Program (CHIP) more affordable for at-risk patients and families. We rely on dental faculty to train the next generation of oral health providers, but too often, these educators find themselves pushed to work in private practice in order to pay off their student loans. The Dental Loan Repayment Assistance Act will ease some of this financial burden and allow faculty members to stay where they are needed most by eliminating certain loan assistance benefits from counting as taxable income. For low-income children, the CHIP program provides access to affordable oral health care. The Ensuring Kids Have Access to Medically Necessary Dental Care Act makes oral
health more affordable by eliminating annual and lifetime dollar limits for dental care provided under CHIP and requires that CHIP wraparound dental coverage be the same as dental coverage for CHIP enrollees.
The ongoing novel coronavirus (COVID-19) pandemic has decreased access to oral health care. Though patient volumes have improved since last spring, recent surveys from the American Dental Association (ADA) indicate that since August many private practices have been operating at around 80 percent of pre-COVID-19 patient volumes while public health practices have been operating at around 60 percent of pre-COVID- 19 patient volumes. Patients nationwide have experienced restrictions throughout the pandemic impeding their ability to visit health professionals like oral health practitioners, while dental practices have experienced financial difficulties brought on by the pandemic. Increases in operating costs to enable safe operations, such as purchasing personal protective equipment (PPE), have strained dental practices' financial resources. These added costs, coupled with reduced patient volume, have led to nearly 60 percent of dental practices applying or planning to apply for small business loans under the Paycheck Protection Program (PPP).
As patients and providers alike currently struggle with oral health access issues, it is critical that the pandemic not compound access to care inequities. In particular, these challenges are cause for concern for at-risk populations such as communities of color, who experienced oral health disparities before the pandemic began. As families and patients nationwide struggle to access care at this incredibly challenging time, I am introducing these two bills to ease the financial burden of dental professionals and promote increased access to oral health for low-income beneficiaries.
There are nearly 6,500 dental health professional shortage areas nationwide. These are areas where nearly 60 million Americans, including 835,000 Marylanders, struggle to find a dental provider, even with insurance coverage. By 2030, the Department of Health & Human Services (HHS) projects that the United States will have a national shortage of 16,000 dentists. We can only hope to solve this problem if we can recruit and retain enough faculty to train the next generation of dentists and dental hygienists. Crippling educational debt should not prevent our Nation from having the oral health care providers it needs, and the Dental Loan Repayment Assistance Act will help address that
I would also like to take this opportunity to acknowledge that February is National Children's Dental Health Month. Since 1981, this month has afforded us the opportunity to acknowledge the importance of children's dental health. We recognize the significant strides we have made, but we also acknowledge the work that remains to be done. I invite my colleagues to join me to use this month to renew our commitment to ensuring that all children in our country have access to affordable and comprehensive dental services. As former U.S. Surgeon General C. Everett Koop said, ``there is no health without oral health.''
Tooth decay--despite being largely preventable--is the single most common chronic health condition among children and adolescents in the United States. It is four times more common than early-childhood obesity, five times more common than asthma, and 20 times more common than diabetes. Among children in families living below the federal poverty line, 52 percent have cavities. Children with cavities in their primary or ``baby'' teeth are three times more likely to develop cavities in their permanent, adult teeth, and the early loss of baby teeth can make it harder for permanent teeth to grow in properly. If tooth decay is untreated, it not only can destroy a child's teeth; it can have a debilitating impact on his or her health and quality of life.
Many of my colleagues have heard me speak before about the tragic loss of Deamonte Driver, a 12-year-old Prince George's County resident, in 2007. Deamonte's death was particularly heartbreaking because it was entirely preventable. What started out as a toothache turned into an abscess and then severe brain infection that an $80 extraction could have prevented. After multiple surgeries and a lengthy hospital stay, Deamonte tragically passed away--fourteen years ago and just a few miles from where we gather here in the Senate Chamber.
Even in less tragic cases, tooth and gum pain can impede a child's healthy development, including the ability to learn, play, and eat nutritious foods. Recent studies have shown that children with poor oral health are nearly three times more likely to miss school due to dental pain, and children reporting recent toothaches are four times more likely to have a lower grade point average than their peers who do not suffer from dental pain. Tooth decay and oral health problems also disproportionately affect children from low-income families and minority communities. According to the National Institutes of Health, approximately 80 percent of childhood dental disease is concentrated in 25 percent of the population. These children and families often face inordinately high barriers to receiving essential oral health care and, simply put, the consequences can be devastating.
In 2009, Congress reauthorized the Children's Health Insurance Program with an important addition: a guaranteed pediatric dental benefit. Today, CHIP provides affordable comprehensive health coverage--including dental coverage--to more than 9 million children. Thanks to CHIP, we now have the highest number of children with medical and dental coverage in history. In addition, in 2010, Congress included pediatric dental services in the set of essential health benefits established under the Affordable Care Act. I am pleased to say that our actions have been working, and our numbers are improving. In 2004, nearly 23 percent of all children had untreated tooth decay. In 2016, that number had dropped to 13 percent.
I am very proud that my State of Maryland is recognized as a national leader in pediatric dental health coverage. In a 2011 Pew Center report, ``The State of Children's Dental Health,'' Maryland earned an ``A'' and was the only State to meet seven of eight policy benchmarks for addressing children's dental health needs. In addition, in the Maryland Health Benefit Exchange, very qualified health plan now includes pediatric dental coverage, so families do not have to pay a separate premium for dental coverage for their children and do not have a separate deductible or out-of-pocket limit for pediatric dental services.
I am also proud to say that Maryland Medicaid does not place a lifetime or annual limit on pregnant women or children receiving dental benefits under CHIP. This ensures that preventive dental care like exams and cleanings, fillings, crowns, root canals, and dentures are not out of reach for low-income Marylanders because of cost constraints. This benefit is critically important nationwide as millions of Americans have joined Medicaid in the past year due to the pandemic.
Not every State has the same benefit structure for CHIP as Maryland, however, which means that new and existing Medicaid beneficiaries may have limits on the types of services they can access. As we know from the terribly tragic example of Deamonte Driver, no family or child should ever face cost constraint decisions for basic oral health care. This is why I have introduced the Ensuring Kids Have Access to Medically Necessary Dental Care Act, to protect access to oral health care for millions of CHIP and Medicaid enrollees and ensure that the pandemic does not reverse the progress we have made in oral health.
I urge my colleagues to join the senior Senator from Mississippi (Mr. Wicker) and me in supporting the Dental Loan Repayment Assistance Act to help address our critical nationwide shortage of dental healthcare providers and especially dental faculty. We cannot continue to allow crippling graduate student debt to deprive the American people of the teachers and mentors we need to train the next generation of oral healthcare providers. I similarly urge my colleagues to join the senior Senator from Michigan (Ms. Stabenow) and me in supporting the Ensuring Kids Have Access to Medically Necessary Dental Care Act to improve access to oral health care for low-income beneficiaries. We must learn from the tragic example of
Deamonte Driver, and ensure that cost constraints are not a barrier to accessing oral health care.
