Letter to Hon. Charles S. Schumer, Senate Majority Leader, and Hon. Nancy Pelosi, Speaker of the House - Barragán, Kelly, Ruiz, Beatty, Chu and Jayapal Call on Leadership to Modernize Medicaid to Include Mandatory Adult Dental Coverage

Statement

Dear Speaker Pelosi and Majority Leader Schumer,

Thanks to your leadership, the Build Back Better Act promises to be the most significant
investment in health equity and access to health care since the passage of the Affordable Care
Act. Through provisions such as those to extend Medicaid coverage to one year postpartum and
close the Medicaid coverage gap, this legislation stands to address longstanding inequities in
access to health care. However, the legislation does not address one of the starkest health
inequities in the health care system. The current patchwork of adult dental coverage in the
Medicaid program has devastating consequences, in particular for people with low incomes;
Black, Hispanic, Asian and Pacific Islander populations, and other people of color; tribal
communities; people with disabilities; and those in rural America.

We now have a unique opportunity to close a glaring gap in Medicaid coverage and ensure that
every person who relies on the program receive the dental care they need, regardless of where
they live. As the Build Back Better Act is considered by the Senate, we urge you to support the
addition of provisions that would make comprehensive dental care a mandatory
component of Medicaid coverage for all enrolled adults while maintaining current
provisions in the House-passed bill.

Adult dental coverage is optional for state Medicaid programs. As a result, adult dental benefits
vary widely across states, and some states don't cover it at all. This puts care out of reach for
millions of people; further stresses underfunded tribal health systems; and compounds systemic
barriers to care in marginalized communities. Despite increases in health coverage nationwide,
cost barriers to dental care for low-income adults have only increased in recent years, with Black
and Hispanic communities reporting the highest financial hurdles to accessing the care they need.
But making adult dental coverage mandatory in Medicaid can help alleviate these inequities.

Moreover, disparities in adult dental coverage are harming America's children. When parents
lack dental coverage, their children are more likely to face delays in getting needed care or
forego care altogether. These gaps most harm children of color and those in low-income families.
However, when state Medicaid programs provide dental coverage to parents, children are more
likely to get the dental care they need.

These changes are also vital for America's economy and workforce. Robust Medicaid adult
dental coverage can improve employability, while reducing associated racial inequities in the job
market. Good oral health can also increase wages for women in the workforce. These gains could
be pivotal for people recovering from pandemic unemployment, which most hurt women, tribal
communities, and communities of color.

This policy is both cost-effective and popular, as evidenced by broad support for the Medicaid
Dental Benefit Act (H.R. 4439). Recent research suggests that extending Medicaid adult dental
benefits could lead to significant savings. With improved oral health, the policy could save at
least $273 million annually in medical costs related to diabetes, heart disease, and pregnancy. It
could also lower overall state spending on dental care. In addition, greater access to dental care
would reduce other unnecessary health spending, such as averting hospital emergency
department visits for dental pain. This could save the U.S. health system $2 billion per year.

By adding Medicaid adult dental coverage to the Build Back Better Act, Congress can deliver
stable and comprehensive dental coverage to all adults who count on Medicaid, no matter where
they live. Doing so can continue to promote a sustainable economic recovery and to reduce vast
health inequities across our country.

Sincerely