Unintended Consequences: House Health Care Reform Bill Would Disrupt Dental Coverage, Limit Competition


Amendments needed to achieve reform objectives

December 2, 2009

San Francisco — Health care reform legislation passed by the House of Representatives, unlike the Senate version, threatens to disrupt dental coverage for millions of children, limit competition for dental benefits and disrupt dentist-patient relationships, according to the president of a group of Delta Dental companies.

"If allowing Americans to keep their current health plan is a goal of health care reform, the House bill misses the mark with respect to dental coverage," said Gary D. Radine, president and chief executive officer for the group of companies under common management that include Delta Dental of California Delta Dental of New York, Delta Dental of Pennsylvania and Delta Dental Insurance Company.

"We applaud Congress for tackling health care reform and for mandating children’s dental benefits in both the House and Senate bills" said Radine. "An underreported aspect of the House legislation, however, is that it reduces access to experienced, dental-focused carriers and would disrupt much of the quality dental coverage that families enjoy today."

Nationwide, 97 percent of employer-sponsored dental contracts – covering 128 million individuals – are currently written separately from medical coverage. The House approach to dental benefits ignores this, said Radine, by requiring mandated children’s dental insurance within the new "health exchange" to only be purchased from a full service, medical insurer, and not from a dedicated, dental-focused carrier. At the same time, adult dental coverage under the House bill would only be available for most parents as a second, separate dental policy that they could only purchase outside the exchange.

Families with group health coverage through their employers, meanwhile also face a problem under the House bill: Employers would also be required to buy children’s dental coverage only through medical carriers. With their focus on medical and not dental, many of these insurers are likely to have different, smaller dental networks, which means millions of children could lose access to the family dentist they see today.

"This disruption of coverage and splintering of dentist-patient relationships were probably not what lawmakers had in mind when they supported the House bill," said Radine. "The provisions governing dental were to some extent buried within the bill’s small print, but there is nothing small about the impact these provisions would have on American families and their dentists."

In contrast to the House bill, the Senate legislation allows children to be covered under policies that can be purchased from either a dental-focused carrier or from a medical insurer offering dental. The combination of separate medical and dental policies is expressly allowed, whether purchased through the new health exchange, or by employers who purchase benefits on behalf of their employees through the private insurance market. A single family dental policy for both children and adults would continue to be available.

"We support health care reform that gives Americans a choice about their dental coverage and that lets people keep their current dental coverage and current dentists if that’s what they prefer," said Radine.

Delta Dental of California, Delta Dental of New York, Delta Dental of Pennsylvania and several other Delta Dental companies under common management provide dental benefits plans to 24 million people in 15 states plus the District of Columbia and Puerto Rico. All are part of the Delta Dental Plans Association (DDPA), based in Oak Brook, Ill., which consists of 39 Delta Dental member companies licensed in all 50 states. The association collectively covers 54 million of the 174 million people nationwide with private dental insurance, making it by far the largest national system of dental plans.

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