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Senator Chandler: We can’t wait any longer. We must focus on oral health now

Senator Chandler: We can’t wait any longer. We must focus on oral health now

August 2, 2017

State Senate Majority Leader Harriette Chandler of Worcester, co-chair of the Massachusetts Legislature’s Oral Health Caucus, is a longtime advocate for oral health and a strong supporter of Health Care For All. Today, she published an op-ed in the Worcester Telegram and Gazette. In her article, Senator Chandler highlights the barriers currently preventing many Massachusetts residents from accessing necessary oral health care services, and encourages the state legislature to take action to address these issues. We are deeply grateful to Senator Chandler for her ongoing leadership on all health care issues, particularly her deep devotion to improved oral health. Here is her op-ed:

As I See It: Closing MassHealth gap in oral health coverage

First as a representative and later as the senator for the First Worcester District, one of my priorities has always been to make sure that people have access to the health care they need and deserve. I know that many are paying close attention to what’s happening in Washington where the future of the Affordable Care Act is on the line – and with it the access to insurance and care for hundreds of thousands of residents of the Commonwealth. We are all worried, yet access to coverage doesn’t solve all the health care problems we face in the state.

There are many other battles that we need to fight to ensure that people can get the treatments and preventive care they need. Even with more than 97 percent of the Massachusetts population covered by medical insurance, many still struggle to access oral health care – which is just as important. They struggle because our fragmented system of care separates the mouth from the rest of the body. For too many, health coverage stops short of comprehensive dental care. Quite simply for them, dental services are out of reach.

Those who are lucky have two insurance cards: one to see a medical doctor and another to see a dentist. However, even with the right card, many people cannot afford the out-of-pocket expenses that accompany much needed dental services, leading many to forego this care altogether.

I recently read an “As I See It” column published in this section written by a well-respected member of our community highlighting the challenges immigrants face when accessing oral health services. In her article, Anh Sawyer, executive director of the Southeast Asian Coalition, rightfully points out the need for increased awareness and for better integration of services, although cost remains a problem.

I agree. Educating consumers about the link between oral health and chronic conditions is critical.

Under the Affordable Care Act, Massachusetts has expanded Medicaid through the MassHealth system. The new MassHealth Accountable Care Organizations are a great opportunity to integrate dental and medical services. ACOs focus on community health, and are expected to lower prices and incentivize a healthier population. However, we must do more. I see people around Worcester every day facing high barriers to getting the care they need, especially those with limited resources. Many dentists don’t accept MassHealth due to low reimbursements. Even if they can find a dentist, many critical services are not covered because of previous state budget cuts.

MassHealth has progressively restored dental benefits, piece by piece, since they were stripped a decade ago. Yet today, 800,000 individuals – including 120,000 seniors and 180,000 people living with disabilities – still do not have coverage for the treatment of gum disease, known as periodontal treatment. They also lack coverage for specific services like root canal treatments (endodontic services), crowns and bridges (prosthodontic services), and some oral surgery procedures such as the removal of benign lesions, which are currently only available to MassHealth members under age 21 or those who are eligible for Department of Developmental Services. Unfortunately, the lack of comprehensive adult dental coverage (which would include all of the services just noted) leads to pain, tooth loss and preventable high-cost emergency department usage, to name a few.

We need to restore those benefits as soon as possible, as they are causing needless pain, suffering, and illness. The legislature has an opportunity to start the process now. I am pleased that the provision to prepare a schedule and cost estimate for restoring MassHealth adult dental care was approved as part of the final Fiscal Year 18 state budget. In addition, Representative John Scibak and I filed legislation to effectively restore all full dental benefits for adults on MassHealth. He and I also co-chair the Legislature’s Oral Health Caucus – the first such legislative caucus in the nation, focusing solely on oral health issues.

Oral health is critical for overall health. We have long known that routine attention to oral health can help prevent or improve many chronic conditions such as asthma, cancer, heart disease, diabetes, arthritis, stroke, kidney disease, high blood pressure and depression. But this is now more important than ever, especially in light of a recent Health Policy Commission report detailing how often people without access to dental treatment utilize emergency care services. If you go to an ER without a dentist in-house, you are not likely to receive dental treatment, and are more likely to be prescribed opiates for your pain. Better access to comprehensive dental care can reduce opportunities for the use (and abuse) of opioids. With the deadly opioid epidemic continuing to affect so many here in Worcester, we can’t wait any longer. We must focus on oral health now.