AUGUSTA — Gina Morin, a grandmother from Lewiston, told legislators recently she hasn’t been able to afford to go to a dentist for more than two decades other than to have teeth yanked out.
“If I had access to dental coverage throughout my life,” she said, “I wouldn’t have my teeth breaking down or falling out.”
Lewiston resident Gina Morin at her home last year. (Portland Press Herald file photo)
Morin spoke to the Committee on Health Coverage, Insurance and Financial Services last month in a bid to convince lawmakers to endorse a bill pushed by Rep. Heidi Brooks, a Lewiston Democrat seeking to expand dental insurance coverage.
Brooks’ bill would broaden dental coverage for adults on MaineCare, require health insurers to provide comprehensive dental services and mandate that dentists do more to provide charity care for impoverished patients.
Another dental bill, sponsored by Rep. John Martin, an Eagle Lake Democrat and co-sponsored by Senate President Troy Jackson, an Allagash Democrat, appears to have a better shot at passage.
Addressing only MaineCare coverage, it would establish a new managed dental care program within the health program for low-income Mainers and add preventive and comprehensive dental services for adults. Children are already covered.
Angela Westhoff, executive director of the Maine Dental Association, commended Martin for pressing ahead with a proposal experts have sought for a decade. Its cost has not yet been tallied up.
She said that MaineCare “provides very limited dental services for adults” so those without coverage or money “turn to emergency rooms seeking relief from pain and infection.”
“At the very least,” Westhoff said, “MaineCare coverage of an adult preventive dental benefit is essential to the health and well-being of needy Mainers.”
“Oral diseases can affect one’s overall health, one’s ability to eat healthy food, and one’s ability to get and keep a job,” she said.
A dentist who described himself as being on the front line, Dr. Jeff Walawender, said he sees the impact daily of Maine’s failure to provide comprehensive dental care for MaineCare adults.
“With just an emergency benefit available, adults who have dental needs routinely seek out expensive emergency room treatment where they only receive an opioid and antibiotic without getting definitive care,” he told legislators.
Walawender said these patients “are not receiving any preventive care including instructions on good oral health habits and sugar reduction” and their “only recourse for decayed or infected teeth is extraction.”
The vice president and general counsel of Northeast Delta Dental, Erica Bodwell, said that Martin’s measure is a critical step “to address the vast, unmet oral health needs of adults and children in Maine.”
She told legislators Delta Dental “feels strongly that oral health care must be available to all, not only to those who can afford it.”
“Maine is one of only 15 states in the country that does not have a Medicaid adult dental benefit beyond emergency palliative care,” she said.
For Mike Andrei of Auburn, the issue is personal.
He told legislators that his wife, Sheila, couldn’t afford regular dental care and wound up in such constant pain that she needed emergency dental surgery in December at “the cheapest place I could find” that extracted “all of her teeth.”
Now the couple is dealing with a $7,200 charge for the surgery and another $1,700 to get dentures, something she can’t have until summer. Andrei said their yearly income is $13,000.
But, he said, somehow he’ll find a way to get her dentures.
“I don’t care if it puts me in the hole even more, she’s gotta have her teeth,” Andrei told lawmakers.
Martin, a former House speaker and legendary figure in Maine politics, told the Committee on Health and Human Services recently that he’s been working on dental care for some time because better access is “imperative for the health of Mainers and is financially beneficial.”
“By getting to the problems early we’ll reduce the need of expensive emergency costs which happen when a dental problem becomes too much to bear,” he said.
Martin said bolstering MaineCare’s coverage will increase provider participation. Less than a third of the state’s dentists participate in the program.
“When parents are covered they will see their dentist and will set up an appointment for their child as well,” he said. “When just children are covered the utilization rate is considerably lower.”
Martin said Maine now ranks 42nd among the 50 states in the percentage of children receiving at least one preventive dental visit annually.
“By providing a greater dental benefit we can begin to ensure we are at the top of taking care of Mainers, not at the bottom,” Martin said.
Walawender, the chief dental officer for Community Dental, said that poor oral health and missing teeth “affect people’s ability to get jobs, especially in the service industry.”
Getting them the care they need at the right time, he said, can make all the difference.
“When a person goes from having no front teeth, not being willing to smile or apply for a job, to feeling like they can show their face to the world, we are giving them a tool to help them feel confident enough to get employment which may lift them out of poverty,” Walawender said.
While strongly endorsing an expansion of MaineCare dental coverage, Delta Dental opposed Brooks’ bid to require individual and group health care plans to include a comprehensive dental benefit.
It said stand-alone plans like the one Delta Dental offers are more affordable, in particular because there isn’t a high deductible to meet before insurance help kicks in. It said that adding a mandate for dental coverage is both unnecessary “and potentially harmful.”
The Maine State Chamber of Commerce also expressed opposition to new efforts to mandate more insurance coverage with its accompanying impact on the cost of providing health care benefits for employees.
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