Senate Democrats are proposing a budget provision that will allow Medicare to include coverage of dental, vision and hearing expenses.  If this provision were to be included in the budget, many believe this would be one of the biggest changes to Medicare since the program’s inception.  More specifically, the dental component, which is the largest portion of the provision, would have a ripple effect that could touch all aspects of the dental industry.

The provision to cover dental, vision, and hearing coverage is expected to cost about $350 billion over 10 years.

Insurance companies are generally opposed to the provision, as many Americans who purchase dental insurance plans will move to Medicare coverage, thus causing a loss of revenue for insurance companies.

Many feel that there could be an adverse effect on dentists, as Medicare would likely create lower payments for a myriad of dental services.  Furthermore, even if a dental professional doesn’t take Medicare, it is possible that Medicare’s involvement in dental services will create downward pricing pressure for all dental professionals. 

The ADA has publicly stated that instead of providing this coverage to all those who are eligible for Medicare, they are pushing to limit coverage to those seniors who are in the lowest income bracket.  Specifically, they are endorsing putting a limit on eligibility to those seniors whose income is less than three times the federal poverty line.

AARP is supportive of the provision as it increases benefits for seniors.  Some groups are also lobbying that there are other more critical medical services should be covered instead of dental, vision, and hearing.  Others are advocating for a phase-in of the benefits over time. 

The overall budget requires approval from both chambers of Congress by a simple majority.  While this is not the first time that Congress proposed to include these benefits into Medicare, many feel that this is the closest it has come to enactment since Medicare’s inception due to the slim majority that Democrats hold in both chambers.  However, for the budget to pass, it would require most Democrats in the House, and all Democrats in the Senate to vote for it. 

If agreed upon, the bill would go into effect in the fall.