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Bill Would Add Preventive Dental Services To MaineCare

In this Wednesday, May 27, 2020 photo, dentist Dr. Kathleen Saturay wears additional protective equipment, including a face shield and disposable mask over a respirator mask, as she exams a patient in Seattle.
Elaine Thompson
AP file
In this Wednesday, May 27, 2020 photo, dentist Dr. Kathleen Saturay wears additional protective equipment, including a face shield and disposable mask over a respirator mask, as she exams a patient in Seattle.

A proposal to expand dental coverage for low income adults who receive MaineCare got another chance Monday before the legislature's Health and Human Services Committee.

Dozens of people and advocates spoke in support of the bipartisan bill, which is similar to one introduced last year that received initial support but died due to the coronavirus pandemic.

Maine is one of 10 states that only provides emergency dental coverage for low income adults under their Medicaid programs. Democratic House Speaker Ryan Fecteau says that policy perpetuates low quality care and is also financially wasteful. A state task force in 2012 found that Maine pays $17 million a year in emergency room dental care.

"Again, I'll just repeat that — that's $17 million in emergency room care that could have been avoided if the patient had received dental treatment prior to," he says.

Fecteau was speaking during a virtual press conference Monday to unveil the bipartisan bill he's sponsoring with Republican Representative Sawin Millett. It would expand dental coverage under MaineCare to include more comprehensive services, including preventive care. Millett says the legislation is long overdue.

"Today's investments bring tomorrow's dividends," he says.

Meaning, he says, that the bill not only makes a human investment by providing much needed dental care; it also has financial benefits. That's an assertion that's supported by research, says Marko Vujicic. He's an economist with the American Dental Association's Health Policy Institute.

"More than a third of low-income adults in Maine report that oral health conditions limit their ability to interview for a job," he says.

"It also affects confidence and the ability to communicate effectively in the workplace," says Kim Hammill of Levant, who was among the dozens of people who testified in support of the bill during a public hearing before the legislature's Health and Human Services Committee on Monday. Hamill says she desperately needs new dentures.

"I work full time at a mental health clinic and have a full roster of clients. I have anxiety about my dentures falling out while I work with my clients. It's unnecessary and it's an upsetting distraction," she says.

Hammill says she has a college-age daughter who also has dental issues. Between the two of them, she says she's looking at a $20,000 dental bill.

Kayla Kalel of Bangor told the committee she also needs thousands of dollars of dental work that MaineCare currently doesn't cover. As a single mom and a soon-to-be graduate from the University of Maine at Augusta, Kalel says she sometimes worked 50 hour weeks on top of her studies to avoid taking out student loans. But over the past three semesters, she's had to take out $6,000 in loans for dental care.

"Which is so disheartening when we remember that this is my reality simply to keep the teeth that are in my mouth and reduce daily chronic pain," she says.

Kalel, who is in recovery from substance use disorder, says she's already lost several teeth.

"I think it's important to also mention that folks like myself who identify as being in long term recovery will continue to have a hard time doing the amazing work in the community if our physical health needs are not met," she says.

No one testified against the bill, which is similar to one last year that won unanimous support in committee.

This year's bill adds a provision that requires Maine's Department of Health and Human Services to report on demographic data and efforts to reduce oral health disparities among racial minorities and tribal populations. As for cost, Kathy Kilrain del Rio of Maine Equal Justice says it's important to remember that it's not just state dollars that would cover expanded care.

"I also want to highlight that this benefit would allow Maine to bring in more than $17 million a year in federal health care funds," she says.

According to the fiscal note from last year's bill, the cost to the state is estimated at just under $4 million per year.

But the Health Policy Institute says that improved oral health would lower overall medical costs, which would translate into an annual net cost to Maine of $2.7 million. State lawmakers are also considering several other measures aimed at expanding dental care for low-income Mainers.