Bill Seeks to Expand VA Dental Coverage; Links to Overall Health Cited

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By Sandra Basu

WASHINGTON — With research increasingly demonstrating a link between poor oral health and cardiovascular disease, diabetes and other conditions, fewer than half of the veterans receiving VA healthcare services also are eligible to receive dental services, according to the chairman of the Senate Committee on Veterans Affairs.

To remedy that, Sen. Bernie Sanders (I-VT) introduced a bill last month that would require VA to extend access of dental services to enrolled veterans not already eligible for this benefit.

Each year, more than 6.5 million veterans receive VA health care services but “fewer than half of these veterans are eligible to receive VA dental care,” according to Sanders.

“We are introducing legislation that would for the first time allow veterans to get dental care other than service-connected. Right now, if you are service-connected, you get good quality dental care. If you are not, you don’t,” he said during a hearing held last month.

The bill would create a three-year pilot program providing dental care and treatment to all enrolled veterans that would be consistent with the dental services and treatment provided by VA to veterans who are 100% service-connected disabled. The legislation would authorize VA to provide these dental services at 16 locations, including VA medical centers, federally-qualified health centers, and  Indian Health Service facilities. It also would provide contract dental care to veterans enrolled in VA’s health care system as well as education to promote oral health.

The Minneapolis VA Dental Service provides multi-specialty care to veterans who meet eligibility requirements.

Meanwhile, VA announced last month, after the bill’s introduction, that it is partnering with Delta Dental and MetLife to allow eligible veterans and Civilian Health and Medical Program beneficiaries to purchase dental insurance.

According to VA, the three-year pilot is designed for veterans with no dental coverage, or those eligible for VA dental care who would like to purchase additional coverage.  There are no eligibility limitations based on service-connected disability rating or enrollment.

“This new dental program is another example of VA creating partnerships with the private sector to deliver a range of high-quality care at an affordable cost, for our nation’s veterans,” VA Secretary Eric Shinseki said in a written statement.

Sanders explained in a written statement that bad oral health “impacts overall health, including increased risk of diabetes, heart disease, and poor birth outcomes.”

“According to the National Institutes of Health, oral health should not be interpreted as a separate issue from general health,” he said in the statement.

Oral Health

VHA officials said they would offer a formal view on the bill at a later date. Robert L. Jesse, MD, PhD, VA’s Principal Deputy Undersecretary for Health, acknowledged, however, that a lack of access to dental care is a “serious issue” in the U.S and “by that very nature it is an issue for veterans.

“I am a cardiologist, and it has been known for 20 years that periodontal disease has a linkage to heart attacks. It creates a systemic inflammatory state which drives a number of different issues,” he told lawmakers. “So dental health is a part of a holistic approach to health as in other forms.”

Sanders asked Jesse whether he anticipated that many veterans that would take advantage of the opportunity if access to dental care is expanded to them.

“I can tell you that there would be,” Jesse said.

VSO representatives told lawmakers that they also support the bill.

“Several studies have shown that poor dental health contributes to and in fact leads to deterioration of the overall physical and mental health. This being so, the case is compelling to add dental care to the package of benefits to patients at VA healthcare facilities who are not 100% service-connected disabled,” Vietnam Veterans of America Executive Director for Policy and Government Affairs Rick Weidman told lawmakers in a written statement.

The Disabled American Veterans also is behind the bill but said in a written statement that it did not support a section of the bill that stated that VA “may collect copayments for dental services and treatment furnished under the pilot program.”

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