Oral Health 2020 is helping unify and empower community voices

Hear from so many passionate individuals who are part of the DentaQuest Foundation's Oral Health 2020 National Network, which is working to address oral health equity, policy, and ultimately improved oral health for all.

Learn more about the movement: http://dentaquestfoundation.org/oh2020

Friday Federal Roundup: CBO, CHIP, and More

As a partner to states and the largest Medicaid / CHIP dental benefits administrator in the country, we at DentaQuest must stay updated on the latest health care policy trends - in large part because anything in the health space affects the oral health space.

Recent federal health reform proposals could have significant implications for Medicaid programs, exchange populations, and oral health coverage for low-income families. We keep our employees apprised of the latest happenings in Washington D.C. with weekly federal newsletters, and thought this week was particularly relevant for more than our staff.

Here’s this week’s newsletter.

CBO Releases Report on Subsidies 

According to a report released earlier this week by the non-partisan Congressional Budget Office (CBO), insurance premiums for ACA plans would rise 20 percent next year and in some areas of the country, people would not have any insurance options if the Trump administration scraps key ACA subsidies. Trump has repeatedly threatened to pull the ACA subsidies, particularly since Congress failed to pass repeal and replacement legislation before the summer recess. CBO’s analysis also found that eliminating the payments would increase the federal deficit by $194 billion over a decade because of higher spending on premiums subsidies. Trump must decide by early next week whether or not to make next month’s payment.

Congress Turns Attention to CHIP

Funding for the Children’s Health Insurance Program (CHIP) expires September 30th. With Congress out on recess, this leaves few legislative working days to ensure that nearly 9 million children maintain their medical and dental coverage. While CHIP reauthorization has historically been a bipartisan issue through the years, the hotly-contested debates over ACA repeal and replacement have left state officials anxiously awaiting assurances from Capitol Hill that 2017 will be no different. We will continue to monitor federal discussions on the future of CHIP and advocate where possible for the vital inclusion of dental coverage in reauthorization efforts.

Trump Administration Encouraging Medicaid Redesign Efforts, State Innovation

As Congress takes a pause on repeal and replacement efforts while they are on recess, states are looking to the Trump administration in the interim for more regulatory flexibility. CMS is expected to soon approve a Medicaid waiver from Kentucky which among other things would require most Medicaid-eligible adults to work as a condition of receiving coverage. Arizona, Arkansas, Indiana, and Maine are considering similar work requirements. HHS Secretary Tom Price and CMS Director Seema Verma have both expressed that they are in favor of such Medicaid redesign proposals.

Last month Alaska became the first state to get increased flexibility from the administration to prop up its individual marketplace with a reinsurance program. Minnesota, New Hampshire, Oklahoma, and Oregon are some other states that have already filed or are considering similar waiver proposals to submit to CMS.

HHS Proposes to End Obama-era Payment Programs

HHS Secretary Price has announced plans to eliminate two Obama-era Medicare bundled payment programs and scale back on a third. This proposal would cancel initiatives that make hospitals more accountable for the cost of certain joint replacement surgeries and cardiac care, and shrink an existing program covering hip and knee surgeries. This is considered a victory for providers who oppose requirements to participate in new payment models. We will continue to monitor whether or not HHS will take further action to roll back requirements in order to slow down the transition to value-based reimbursement structures.

Dental Coverage has Bipartisan Support among Voters

As the new Trump Administration and Republican Congress begin their work this month, they will have the opportunity to advance conservative priorities through major legislative changes. At the top of their list is repealing the Affordable Care Act (ACA), which will have implications for the dental health and overall health of many Americans.

ACA replacement proposals from President-elect Trump, Speaker Paul Ryan, and the nominee for Secretary of Health and Human Services Rep. Tom Price should signal major changes forthcoming to the health care industry.

The ACA’s Medicaid expansion, essential health benefits, and exchange provisions have increased access to dental care for both children and adults. While the future of these elements is uncertain, we at DentaQuest want to ensure that replacement proposals do not jeopardize this important access to oral health. We’ve made great strides in eliminating barriers to dental coverage for millions of Americans who gained access through the ACA.

As policymakers consider different replacement plans, the role of oral health must remain a priority. 

In a recent survey of 2,000 registered U.S. voters conducted by DentaQuest via Morning Consult, the inclusion of dental coverage in public programs received widespread support from voters of both parties.

The survey showed that:

• 83 percent of respondents think dental coverage should be a part of Medicare
• 83 percent of Republicans agree
• 86 percent of Democrats agree
• 81 percent of Independents agree
• 73 percent of respondents believe dental coverage should be a required benefit in Medicaid
• 64 percent of Republicans agree
• 82 percent of Democrats agree
• 71 percent of Independents agree

Dental coverage is not currently included in Medicare, nor is it a required benefit for adults in Medicaid. A full repeal of the ACA could compound oral health access issues by eliminating Medicaid expansion and the exchanges— two important sources of affordable dental coverage.

Research continues to show a connection between oral and overall health. Dental coverage is a critical first step to improve both oral and overall health outcomes, reduce persistent health disparities, and contain systemic costs.

As policymakers seek to improve our existing health care system, oral health must be a part of the solution. 

It is clear: Dental coverage has demonstrated itself to be a bipartisan priority for the American public. As we enter a 2017 legislative session with significant health care policy changes on the agenda, dental coverage must also remain a priority for Congress.


The full survey conducted by DentaQuest and Morning Consult will be released in 2017.

Oral Health is Now a Leading Health Indicator

By Steve Pollock, President, DentaQuest

At the annual meeting of the American Public Health Association this week, the Department of Health and Human Services (HHS) announced three new categories of Leading Health Indicators for the Healthy People 2020 campaign. The good news is oral health has been identified as a Leading Health Indicator category…finally.

Healthy People 2020 identified 17 oral health goals -- from reducing the rate of dental caries in the primary and permanent teeth of children and adolescents – to increasing the number of children, adolescents and adults who use the oral healthcare system.

HHS named Oral Health a Leading Health Indicator because it is a critical health issue that, if left unaddressed, could result in future public health problems. DentaQuest could not agree more.

Everything we do is focused on our singular mission to improve oral health. Our Preventistry^SM philosophy ensures a unique focus on prevention, disease management, quality care, and cost effective benefit program administration, and recognizes and supports the important provider-patient relationship in achieving good oral health. Our DentaQuest Institute isolates areas where we know there is a better way to prevent and manage oral disease, and works to make new and proven dental therapies routinely available in the dental office. Historically, new evidence-based care learnings take years to become accepted and practiced in the dental office setting, and the Institute is working to change that. Our DentaQuest Foundation is driving a grassroots movement across the nation to improve oral health with its Oral Health 2014 Initiative, awarding 20 state organizations funding and resources to reduce oral health disparities, one of the biggest cost drivers in the American health care system.

We are committed to our mission and intent on setting goals and measuring our success against them. We’re working on that. But with Healthy People 2020’s designation of oral health as a Leading Health Indicator, our ability to affect our mission takes a major step forward. With the endorsement of HHS and the power of Healthy People 2020 focused on oral health improvement, much will be done to prevent oral disease. Our population will be healthier and our state and national health care systems will see costs go down. Without good oral health, it’s impossible to enjoy good overall health.

Oral diseases are almost 100% preventable. With the right focus and resources, oral disease is one chronic health problem that we can target and eliminate – in our lifetime. I am convinced that with a coordinated system of collaboration and persistence, oral diseases can become a thing of the past.