State Health Reform: How Do Dental Benefits Fit In? Options for Policy Makers

This paper discusses the options that states have to include dental benefits in a health care reform plan, if the state desires to do so. Oral health resides, for all intents and purposes, in a different world from general health. Dental care is separate in financing and insurance; provider education, licensing, and regulation; and service delivery. While ambitious health care reform plans have been undertaken in several states and proposed in others, no recent reforms have included dental benefits for the majority of those who are included in the new coverage. The primary barrier for states in including dental coverage is cost – although the traditional separation of general health and oral health – is a factor. States considering adding dental benefits to their health care reform plans have three approaches they can take. They can: use Medicaid as a vehicle for providing dental benefits; offer a private dental insurance product for those not enrolled in Medicaid or already covered by dental insurance; or combine Medicaid and private insurance in a “connector” approach. The paper looks at the advantages and disadvantages of each of these three approaches. It also discusses the continuing importance of public oral health efforts and the dental safety net, whether or not dental coverage is included in health reform efforts.

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