[Congressional Record Volume 151, Number 8 (Tuesday, February 1, 2005)]
[Extensions of Remarks]
[Pages E130-E131]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




            REINTRODUCTION OF THE ORAL HEALTH PROMOTION ACT

                                 ______
                                 

                          HON. BERNARD SANDERS

                               of vermont

                    in the house of representatives

                       Tuesday, February 1, 2005

  Mr. SANDERS. Mr. Speaker, I want to announce today the reintroduction 
of the Oral Health Promotion Act, a bill I previously sponsored in the 
107th Congress. I will reintroduce this bill tomorrow and I urge my 
colleagues on both sides of the aisle to join me as original cosponsors 
on this important legislation.
  Mr. Speaker, oral health care in the United States is in a sad state 
of decay. Congress cannot neglect it any longer. While the number of 
Americans without private health insurance of any kind is staggering 
enough at over 45 million, the number of Americans without private or 
public dental insurance is more than two times that figure. One hundred 
and eight million Americans--at last count--had no dental insurance at 
all: no coverage for emergency services, no coverage for fillings, no 
coverage for braces, no coverage for check-ups. Amazingly, despite 
great advances in oral health sciences, the Surgeon General has 
reported that tooth decay has become the single most common chronic 
childhood disease--five times more common than asthma and seven times 
more common than hay fever.
  What does our neglect of oral health cost us? Surveys have shown that 
dental problems cause children to miss more than 51 million hours of 
school and adults to miss more than 164 million hours of work each 
year. That's a lot of lost education, lost productivity and lost pay. 
And let's be clear--lack of access to dental care does not strike 
evenly across the socioeconomic spectrum. According to the U.S. Surgeon 
General:
  Poor children suffer twice as many cavities as their more affluent 
peers, and their disease is more likely to be untreated.
  Poor children suffer nearly 12 times more restricted-activity school 
days than children from higher-income families. (In my own state, which 
is doing a lot better than the national average on many oral healthcare 
indicators, a recent study found that 23 percent of children in grades 
1-3 experienced 82 percent of all decay found.)
  Medicaid has not been able to fill the gap in providing dental care 
to poor children: Fewer than one in five Medicaid-covered children 
received a single dental visit in a recent year-long study period.
  For each child without medical insurance, there are at least 2.6 
children without dental insurance.
  For every adult 19 years or older with medical insurance, there are 
three without dental insurance.
  Obviously, there are a lot of factors at play in this problem. But 
when it comes down to what we can do to increase access to dental care 
for the largest number of people, the solution, I think, already 
exists. While many other dental providers close the door to Medicaid 
and uninsured patients, often because they do not receive adequate 
reimbursement for the services they provide, Federally Qualified 
Community Health Centers provided dental services to millions and 
millions of them last year. Currently, over 1,000 community, migrant, 
and homeless health centers serve over 15 million people in 3,600 urban 
and rural communities in every State and territory.
  It is clear that focusing on expansion of the dental care 
infrastructure through these and similar community-based providers will 
get us the biggest bang for our buck. Community health centers--which 
serve all patients in their communities regardless of their ability to 
pay--are on the front lines of getting dental care to those who are 
least likely to get it, namely those on Medicaid and those with no 
insurance at all. A lot of praise has been showered on this successful 
program for many years and from both sides of the aisle, including from 
President Bush, and rightly so. Now I think we really need to put our 
money where our mouths are and fund the creation of more dental care 
infrastructure based on the community health care model.

  That is why I am introducing the ``Oral Health Promotion Act'' to 
address our national crisis in access to dental care. This bill will 
make a serious commitment to developing a dental health care 
infrastructure across our country and expand access to high-quality, 
affordable dental and health care for all Americans. It will:
  (1) Create a $140 million fund for the workforce, capital and 
equipment needed to establish or expand oral health services at 
community health centers, school-based dental centers (and other 
community-based sites) across the country;
  (2) Provide states with an enhanced federal match (FMAP) for agreeing 
to cover full adult dental benefits under the Medicaid program;

[[Page E131]]

  (3) Require that State Children's Health Insurance Program (SCHIP) 
coverage include dental benefits for children;
  (4) Authorize and provide additional funding for states to provide 
dental services under SCHIP as a supplement to other health coverage;
  (5) Create incentives for states to pay market-based reimbursement 
for dental services under SCHIP and Medicaid and to cover the Medicaid 
level of dental benefits under SCHIP.
  I urge my colleagues to join me as original cosponsors of this 
important legislation, which I will introduce tomorrow.

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