Health

West Virginia Senator Manchin Introduces Democratic Seniors Dental Care Plan


Sharon Marchio misses having teeth to eat, talk and laugh.

For the past few years, after having her last tooth extracted, she has been using dentures. “My dentist calls them my floating teeth because no matter how much adhesive you use, if you eat something hot or warm, they will loosen,” says Marchio, 73, of Clarksburg, West Virginia. come out and cause pain,” said Marchio, 73, of Clarksburg, West Virginia.

Marchio believes that tooth loss is just part of getting older. It is quite common in West Virginia, where a a quarter of people aged 65 and over no natural teeth, the highest rate of any state in the country, according to federal data.

Like half of all Medicare enrollees nationwide, Marchio doesn’t have dental insurance. Worried about the cost led her to skip regular cleanings and checkups, important steps to preventing infection and tooth loss.

Medicare doesn’t cover most dental care, but consumer advocates had hoped that would change this year after Democrats took control of the White House and Congress. President Joe Biden and progressive members, led by Senator Bernie Sanders, have sought to add benefits to the massive domestic spending package, the Better Rebuilding Act, which Democrats are seeking to seek. through the.

But those opportunities are look slim because at least one Democratic senator – Joe Manchin of West Virginia – opposes adding dental and other benefits to Medicare beneficiaries. He said it would costs to the federal government too much.

In a Senate with an even split between Republicans and Democrats, Manchin’s loss of votes is likely to sink the proposal, which is unlikely to receive any Republican votes. .

Last month, the House passed Democrats’ roughly $2 trillion domestic priority package, which includes health measures, free preschools, affordable housing programs, and other programs. climate change initiative. It added hearing services coverage for Medicare but no dental benefits. The package is expected to be revised in the Senate, and Democratic leaders hope a vote will take place in the chamber before the end of the year.

In West Virginia, one of the most heavily Republican states in the country, oral health advocates and progressives say it’s disappointing that Manchin will stand in the way of adding dental coverage. for people receiving Medicare – especially with the state’s poor oral health record.

“Unfortunately, our senator – with whom I respect and agree on so many things – will draw a position on this matter,” said Fotinos Panagakos, associate dean for research at the University School of Dentistry. West Virginia and is a member. of the Santa Fe Group, a research group comprised of academics, industry executives, and former government officials promoting Medicare dental benefits. “That would be a huge benefit.”

West Virginia has the third-highest percentage of people 65 and older, behind only Florida and Maine. Panagakos said that nearly 300,000 Medicare recipients in West Virginia would receive dental benefits under the bill. However, Manchin’s efforts are unlikely to cost him politically. He won’t be running for re-election until 2024.

“What political price do you pay when four other Republicans vote ‘no’ against everything?” Ryan Frankenberry, state director for the Progressive Labor Family Party of West Virginia, said, referring to three members of the state’s House of Representatives and Senator Shelley Moore Capito, who are all opposed to the bill. “It’s hard to blame one person for not transcending interest when every other Republican vote has gone against it.”

Manchin’s opposition, says Manchin, stems from a need to respond to political pressures while representing an increasingly conservative state – and arguments from conservative commentators that Medicare is becoming broken. debt and increase the federal deficit.

Manchin, who did not respond to a request for an interview, raised concerns about the new addition of Medicare spending as the Medicare Part A hospital trust is expected to default in 2026 if Congress does not act. which move. But that fund would not include the proposed dental benefit; it will become part of Medicare Part B, which includes outpatient services such as doctor visits.

Manchin has also suggested that new social programs are being advanced by Democrats in the Better Rebuilding Act. should be checked vehicle – in essence, provide coverage only to lower income earners.

Dentists are concerned that Medicare — like Medicaid — will pay less than they normally charge, said Richard Stevens, executive director of the West Virginia Dental Association.

The American Dental Association has also called for limiting any new Medicare dental benefits through vehicle testing. ADA officials say a vehicle inspection would ensure that benefit is helping those who really need it and saving the Medicare program money.

But critics say the ADA’s stance is an attempt by the powerful dental lobbying panel to destroy the interest – because they know Congress has little appetite for transitioning to trial vehicles. experience in Medicare. The plan remains popular largely because everyone 65 and older enjoys all of its benefits.

“On the surface, their position sounds altruistic,” says Michael Alfano, who was dean of the New York University School of Dentistry and helped found the Santa Fe Group. “But Congress is not interested in making it a tried-and-tested benefit.”

Alfano said: “While the addition of the Medicare benefit will increase demand for dental services, it will also reduce what are seen as dentists’ most lucrative patients, who pay out of pocket and get out of pocket. benefit from the insurance company’s discounted premium. “In my opinion, the ADA is not in the public interest at all – they put the financial returns of dentists at the top of the ledger when developing this approach,” he said.

Alfano said there is still hope about the eleventh change in the bill. “It’s not dead yet, but I’d be lying if I said I wasn’t disappointed,” he said.

Seniors in West Virginia have other options for getting dental coverage.

Many people receive several benefits when they enroll in private Medicare Advantage plans. And in January, West Virginia added adult dental benefits to Medicaid, the federal-state health insurance program for low-income people that gives enrollees maximum benefits. annual maximum is $1,000. Previously, West Virginia was one of about a dozen states that did not offer dental benefits to adults receiving Medicaid or were covered only for emergencies.

As of September, about 53,000 of the nearly 390,000 adults enrolled in West Virginia’s Medicaid program have used this benefit.

Stevens of the West Virginia Dental Association said he couldn’t explain why so few Medicaid enrollees have used the benefit, though he noted that the $1,000 maximum may not be enough to convince some people seek care. “For those with more serious oral health conditions, $1,000 doesn’t go too far,” says Stevens. “Hardly worth the patient’s time and not worth the dentist’s time.”

Craig Glover, CEO of FamilyCare Medical Center in Charleston, West Virginia, says the Medicare benefit will benefit the many older patients who come to his dental practice. He said some patients do not return for the necessary follow-up care because of concerns about cost.

Without dental insurance, older adults in West Virginia rely on community health centers — which offer a sliding fee scale based on income — and free health clinics for care. But they may still face costs that are out of reach or have long waits for care.

Office director Gail Marsh said dental appointments at the Susan Dew Hoff Memorial Clinic in West Milford, where Marchio has been treated, are booked months in advance.

KHN (Kaiser Health News) is a national newsroom specializing in the production of in-depth coverage of health issues. Along with Policy Analysis and Exploration, KHN is one of the three main activities in KFF (Kaiser Family Foundation). The KFF is a nonprofit organization privileged to provide information on health issues to the nation.

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