WASHINGTON – U.S. Senate Majority Whip Dick Durbin (D-IL) today took to the Senate floor to deliver a speech on his new bipartisan legislation with U.S. Senator Roger Marshall, M.D. (R-KS) to reauthorize funding for the Centers for Disease Control and Prevention’s (CDC) Oral Health program for the next five years. In his remarks, Durbin spoke about the impetus of the Promoting Dental Health Act, hearing stories from across Illinois, including rural and dental shortage areas, where children with tooth decay and other dental conditions faced extensive wait times to access necessary treatment while facing excruciating pain.
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Durbin began his speech by recognizing the highest enrollment numbers to date for health insurance coverage under the Affordable Care Act. Durbin recalled his own experience being uninsured when his family faced health complications, and reiterated the importance of ensuring quality, accessible health care options for Americans.
“Last week, we received remarkable news about a milestone in Americans' health care. A record 20 million Americans are now covered by health insurance under the Affordable Care Act. This is a sign of progress as we improve the quality of life and health care protections under President Biden. Having quality, affordable health care coverage means having peace of mind if you get a diagnosis or an accident or if you needed access care and you're facing medical debt,” Durbin began. “I know this story. I've been there. I was a law student at Georgetown when my wife and I were blessed with the birth of our first child, a baby girl born with a serious medical condition. As a young father without insurance, I can tell you there's no greater feeling of helplessness. That is why Democrats have been committed to expanding health insurance to millions of more Americans and ensuring it contains protections for patients with preexisting conditions.”
While the Affordable Care Act had expanded health care options for Americans, there are remaining gaps in coverage, including in dental care. In speaking with Carolin Harvey, Mayor of Carbondale, Illinois, Durbin learned that the community is facing a shortage of dentists, resulting in delayed care for patients. There are 10 rural counties in Illinois that have only a single dentist to serve the community. In Lawrence County, there is only one dentist for 15,000 people, a ratio that is 11 times worse than the national average.
“I spent the August recess last year visiting small towns in Southern Illinois. I met with the new mayor of Carbondale, Illinois… She said, ‘Senator, we just don’t have enough dentists for kids in Southern Illinois,’” Durbin said. “What’s the consequence of having a shortage of dentists? Patients’ conditions worsen as they face delays to get necessary care.”
Durbin went on to share the story of an 18-month-old constituent who was found to have significant tooth decay, but while she was covered by Medicaid, the shortage of dental health professionals forced her to wait almost a year to receive adequate treatment.
“My office was recently contacted about a child in Southern Illinois who was found to have tooth decay in her 18-month checkup. The patient is covered by Medicaid, and her parents had a hard time finding a dentist who would even see her… After nearly a year, the patient was finally treated for severe tooth decay, erosion of the upper incisor teeth, and a large tooth abscess. But her condition did not improve after multiple rounds of antibiotics, so her dentist called around to find a specialist to see her,” Durbin said.
“They were told by the specialist, ‘Unfortunately, we have over 200 patients on our waiting list, so we really cannot help her. This child is going to have to develop a much worse condition known as facial cellulitis, then she can get sent to an emergency room and we can see her,’” Durbin continued. “Her dentist called a specialist in a neighboring state. Thankfully, they were able to perform emergency surgery to remove the decayed teeth, but not before risking life-threatening illnesses… That is unacceptable.”
Durbin then noted that the National Health Service Corps (NHSC) can help remedy the dental professional shortage. Durbin has long been a supporter of this federal program, and he authored a provision in the American Rescue Plan to invest $1 billion into scholarship and loan repayment awards for dentists and other clinicians serving in shortage areas under the NHSC. Durbin also introduced the bipartisan Restoring America’s Health Care Workforce and Readiness Act, which will reauthorize and increase funding for NHSC. Last fall, the Senate Committee on Health, Education, Labor, and Pensions (HELP) passed a bipartisan package that included significant new funding for NHSC.
“Thankfully there’s a federal program that can help, the National Health Service Corps. It provides scholarship and loan repayment to dental, medical, and mental health care providers who work rural and urban areas of need. It is the primary federal program intended to build the pipeline of health care providers and address shortages… But $310 million in mandatory funding for this program will expire at the end of this month. Senator Marco Rubio and I have a bipartisan measure to extend this program and nearly triple its funding,” Durbin said.
Durbin continued his speech, emphasizing that only a quarter of practicing dentists in Illinois accept Medicaid. As a result, kids in Illinois with private insurance are six times more likely to get a dental appointment than those who have Medicaid. Additionally, low reimbursement rates and arbitrary practices by companies that administer dental benefits under Medicaid only contribute to the problem. In November, Durbin sent three oversight letters to DentaQuest, Envolve, and Avesis – three companies that administer dental benefits for Medicaid managed care companies (MCOs) in Illinois – to seek answers on barriers to providing dental care to Medicaid enrollees. The letters raised concerns and investigate certain insurance practices that can limit and discourage provider participation in Medicaid, which exacerbate existing reimbursement rate challenges.
Durbin concluded his remarks by publicly introducing his new bipartisan legislation, the Promoting Dental Health Act.
“Today, I’m announcing a new bill that I’m introducing with Senator Roger Marshall of Kansas. Our bipartisan legislation will authorize funding to the Centers for Disease Control and Prevention to enhance public health activities improving dental care across America. It will support education, data collection, sealant treatments in school, water fluoridation efforts, development of dental workforce, and community outreach such as the distribution of tooth brushes to new parents and children. Illinois has not received funding for this important work in nearly 20 years. I want to change that,” Durbin said.
“If we want to improve the health of Americans, especially kids, then we must invest in preventing cavities, tooth decay, and infections. We also must ensure that patients have access to treatment, regardless of their ZIP code,” Durbin concluded.
The Oral Health program receives $20.5 million in annual funding for a range of public health activities to promote oral health. This funding is allocated to 20 states to prevent cavities, gum disease, and other painful and serious conditions, including by supporting dental education, data collection, school-based sealant care for low-income children, state fluoridation efforts, workforce development, and research into gaps in patient care. However, Illinois does not currently receive this CDC funding because the program is not adequately funded to serve every state. Yet in Illinois, 2.8 million residents live in communities with a shortage of dental providers, and only 37 percent of children covered by Medicaid have a dental visit in a given year.
Video of Durbin’s remarks on the Senate floor is available here.
Audio of Durbin’s remarks on the Senate floor is available here.
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