Dental Care Won't Be Covered In Vt. Health Plan

10/04/12 5:50PM By Bob Kinzel
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The Green Mountain Care Board has voted not to include adult dental services as part of the basic benefit package that will be offered to Vermonters though the Health Care Exchange in 2014.

Under the federal Affordable Care Act, states must include dental services for children in their basic benefit package but the law also stipulates that if a state includes adult dental care in the package, the state must pay the full cost of providing this service.

It's estimated that roughly 100,000 Vermonters will initially get their health insurance through the exchange and the cost of adding adult dental services is around $20 million a year.

The Shumlin Administration opposed the plan because of its cost, and by a 3-to-2 vote, the Board agreed with the Administration's position. Anya Rader Wallack is the chair of the Board. She says the creation of the Exchange isn't the proper time to expand services.

"At least some of us on the Board felt like it was not the best way to solve this problem," said Rader Wallack. "And that what the exchange was intended to is really mirror the current insurance marketplace and create as little disruption and additional cost as possible while offering some improvement in terms of how the marketplace is organized."

Donna Sutton Fay is the Policy Director for the Vermont Campaign for Health Care Security. She's very disappointed by the Board's vote because she says there are at least 60,000 Vermonters who can't afford to see a dentist.

"It's definitely our view that it would be money well spent and it's part of health care," said Sutton Fay. "I mean access to dental is a huge issue in Vermont so it's our view that clearly it would be money well spent."

And Sutton Fay says the vote raises doubt about the Shumlin Administration's commitment to include adult dental services in a Single Payer system in the future.

"So not adding adult dental seems to indicate a lack of commitment to actually covering adult dental even down the road."

Rader Wallack says that's an incorrect conclusion because the purpose of the exchange and the goals of a single payer system are very different.

"One is tinkering around the edges," said Rader Wallack. "The other is really trying to redesign the system so that we can cover the core needs of Vermonters and a pretty compelling case has been made to us that this is a core need."

Rader Wallack says the Board did agree to commission a special study to help determine the most cost effective way to provide dental care to adults in the future.

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