[Congressional Record (Bound Edition), Volume 148 (2002), Part 9]
[Extensions of Remarks]
[Page 12728]
[From the U.S. Government Publishing Office, www.gpo.gov]


        INTRODUCTION OF THE CHILDREN'S ACCESS TO ORAL HEALTH ACT

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                          HON. JOHN D. DINGELL

                              of michigan

                    in the house of representatives

                        Thursday, July 11, 2002

  Mr. DINGELL. Mr. Speaker, tooth decay is the most prevalent chronic 
childhood disease; it is five times more common than asthma, and seven 
times more common than hay fever. Without proper treatment, dental 
caries (tooth decay) can result in serious infection, pain, and 
swelling, interfering with the ability to eat or drink, and, in severe 
cases, sleep or school performance.
  Unfortunately, low-income children suffer disproportionately from 
oral disease. While dental care is covered for children in Medicaid, 
and most states opt to cover it for children in Children's Health 
Insurance Programs (SCHIP), merely covering services does not guarantee 
children will have access to them. Low participation by providers, 
program barriers, and parent's lack of knowledge about the importance 
of early dental care and prevention have greatly contributed to the 
disproportionate number of low-income children who suffer from tooth 
decay.
  Such problems can be overcome. Recent demonstration projects have 
shown that increased attention to the issue coupled with expanded 
federal support can go a long way toward ensuring low-income children 
have access to quality oral health care. My home state of Michigan is 
an example of where change has begun to take hold.
  Michigan tried a new approach to dental coverage when they 
implemented a dental benefit for their SCHIP program. Not surprisingly, 
by paying dentists market rates, simplifying billing procedures, and 
requiring that plans prohibit participating dentists from 
discriminating against SCHIP patients, access and utilization soared to 
levels never seen under Medicaid. Between 70-90% of dentists 
participated in the plan networks and nearly three-quarters of children 
received a dental visit in a year. In comparison, in the Medicaid 
program where similar changes were not undertaken, only 27% of dentists 
participated and barely a quarter of Medicaid children had a dental 
visit. The State of Michigan has had the common sense to expand this 
effort to Medicaid through a demonstration project and the results have 
been similar.
  All children, however, regardless of where they get their health 
insurance, should be able to count on quality dental care. That is why 
Congressman Upton and I are introducing the ``Children's Access to Oral 
Health Act,'' a bill that will provide incentives and new flexibility 
to states to encourage them to improve and expand the provision of 
dental care to low-income children.
  The Children's Access to Oral Health Act establishes improved dental 
care for low-income children as a priority within the Department of 
Health and Human Services by establishing a dental health initiative 
led by a newly created Chief Dental Officer for Medicaid and CHIP. The 
legislation provides grant funding for states to undertake outreach and 
improve coordination in the dental care provided through these 
programs, as well as to improve provider reimbursement rates to secure 
adequate access to services for these children. The legislation also 
provides grants to improve the delivery of pediatric dental services 
through community health centers, public health departments, and the 
Indian Health Service to address problems in areas facing a shortage of 
dental professionals.
  Finally, the legislation ensures that dental care is a part of the 
core benefits package of the SCHIP program and gives states the 
flexibility to provide dental coverage (or supplemental additional 
benefits or cost sharing) for children in families who meet SCHIP 
income requirements but who have private insurance which is inadequate 
in these areas. For every child who lacks health insurance coverage, 
there are 2.6 children who do not have dental coverage. This problem is 
concentrated among low-income families, but currently states' hands are 
tied and they cannot supplement inadequate private insurance with SCHIP 
coverage.
  I believe the Children's Access to Oral Health Act will go a long way 
in terms of improving dental services for children and in reducing the 
dental caries among low-income children. Michigan, like a number of 
other states, has made significant progress in this area, but much more 
can be done. The gains made in the Michigan SCHIP program should be 
expanded to children who have coverage through Medicaid. States that 
have not focused as much attention on this problem can be encouraged to 
do so. This bill will provide incentives, resources, and new 
flexibility for states to tackle this problem. I look forward to 
working with my colleague Mr. Upton as well as our friends in the 
dental community, like Dr. Dan Briskie, in moving this legislation 
forward.

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