Advocates for Maine dental bill press Mills for support

Advocates for low-income Mainers are making a renewed push to provide dental benefits to adult Medicaid recipients in the wake of a failed effort in the last legislative session.

The bill currently before the Legislature would provide dental access for about 70,000 Mainers at a cost to the state of $6.4 million annually. The federal government would pay $17 million into the program.

About 100 Mainers lobbying for the bill on Thursday delivered 1,500 postcards to the office of Gov. Janet Mills, ramping up pressure on the governor to support the measure.

It’s the second attempt in two years to persuade Mills to back a bill that would bring dental care to low-income adult Mainers who currently lack regular access to a dentist. About 330,000 Mainers have Medicaid insurance, which is primarily a program for lower-income people that is funded with a mix of federal and state tax dollars.

The bill, which will go before the Legislature’s Health and Human Services Committee on Monday, is one of the top priorities of Augusta advocacy group Maine Equal Justice.

Rep. Drew Gattine, D-Westbrook, sponsored the measure that stalled in the Legislature last year and has introduced a nearly identical bill for the current session.

He is optimistic about the bill’s prospects this session because dental care is preventive and cost efficient, and forcing people to delay their care until a crisis is “cruel.”

“I think we are going to make a very compelling case,” Gattine said.

Advocates held signs that said “Dental Care is Health Care” and “Help Mainers Smile Again!” in front of Mills’ office on Thursday.

Lindsay Crete, Mills’ spokeswoman, said the dental bill is under review.

“The governor appreciates hearing their thoughts, and her administration is reviewing the legislation,” Crete said.

In a statement to the Press Herald in January 2019, when the bill was first introduced, Mills was noncommittal about adding a dental benefit, but also said that “Maine can do a better job of ensuring proper dental care for all families.”

If approved, Maine would join 33 states that currently have full dental benefits as part of Medicaid. Currently, Maine’s Medicaid program will only cover adult patients who have emergency dental needs.

Children with Medicaid get full dental benefits, but coverage goes away when they become adults. Many low-income or part-time workers do not receive dental benefits with their employment, making dental care inaccessible unless patients pay out of pocket.

Mills has had to consider numerous requests for additional state funding while keeping the budget in check. For instance, lawmakers approved an $8 billion budget last summer, but left $820 million in approved projects unfunded.

Kirk Robbins, of Portland, hopes the new bill passes and is signed by the governor. He said he went without insurance until age 50 and lost all his teeth from gum disease. He got dentures through a charity organization.

“When I had my teeth they were broken and jagged,” said Robbins, a former restaurant cook. “When I opened my mouth they looked like a Halloween jack-o’-lantern.”

Robbins, now 60, said that he had an abscessed tooth in the late 1990s when a doctor told him he had gum disease. But because he didn’t have access to dental care, he couldn’t get care, so he ignored his oral health problems, and they kept getting worse.

“I know I needed to do something about it, but I couldn’t,” Robbins said.

Stephanie Chase, 38, of Augusta, and a Maine Equal Justice employee, said her oral health deteriorated through her 20s, and she wanted to see a dentist but couldn’t afford it.

“If I had been able to see a dentist, I wouldn’t have needed dentures at age 29,” Chase said. She said before she got dentures, she would “always cover my smile when I laughed.”

“The (tooth) pain would wake me up in the middle of the night,” Chase said. “It felt like a lightning bolt and had me on the floor.”

Sue Drew, a dental hygienist in Eastport, said when Mainers “can’t afford preventive care like cleanings and fillings, it can lead to serious chronic health problems or the need for costly emergency room care.”

A 2017 study for the National Association of Dental Plans found that a preventive Medicaid benefit for adults reduces medical costs by 31 percent to 67 percent for patients with chronic conditions, such as diabetes, high blood pressure, high cholesterol and asthma.

“The cost of the bill ($6.4 million) doesn’t even take into account savings from preventing chronic diseases,” said Alison Weiss, communications director at Maine Equal Justice.

Dr. Brad Rand, president of the Maine Dental Association, said that the group strongly supports the bill.

“A comprehensive adult dental benefit is critical to adequately addressing the oral health needs of all Mainers,” Rand said in a statement.

Meanwhile, a separate bill sponsored by Sen. Heather Sanborn, D-Portland, would eliminate waiting periods for pediatric dental patients. Many private health plans have waiting periods of a few months up to a year for newly enrolled patients for common conditions such as filling cavities.