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Dental Coverage Legislation in the 115th Congress

The “Seniors Have Eyes, Ears and Teeth Act” (H.R. 508) would expand Medicare to give beneficiaries coverage for hearing services, dental care, vision exams and devices such as hearing aids and glasses. The bill, authored by Rep. Lucille Roybal-Allard (D-CA) on Jan. 12 already has 126 cosponsors in the House.

"Few bills are ever introduced with the overwhelming support that we have seen for the Seniors Have Eyes, Ears, and Teeth Act, and the reason is clear," Roybal-Allard said in a press release. “If we pass this bill, we can lift Medicare's exclusion of these vital services, and help our seniors enjoy their golden years in good health and with peace of mind.”

In its 50-year history, Medicare has excluded coverage for services related to hearing, dental and vision-related services despite a large number of older Americans who need such items and services.

Hearing loss is estimated to affect 40% of people over 60 years old, a statistic that reaches up to 80% in the 80-and-over category. Older adults account for roughly 80% of all Americans with low vision. Seniors without dental insurance — an estimated 70% of older adults — spent on average $737 on out-of-pocket dental services in 2012.

The Dental and Optometric Care Access Act (H.R.1606), also known as the DOC Access Act, seeks to empower doctors and patients in their dealings with plans, eliminate a growing level of anti-competitive practices in health care, and help improve the overall quality of patient care. This legislation is championed by Reps. Buddy Carter (R-Ga.) and Dave Loebsack (D-Iowa).

Among other protections, the DOC Access Act would prohibit federally-regulated health, vision, and dental plans from:

  1. Restrictions on medical plan participation.
  2. Limits on a doctor's choice of a lab.
  3. Determining prices for non-covered services and materials mandates.

Rep. Carter said dental insurance companies must be prohibited from interfering in the doctor-patient relationship by dictating prices for services they don't even cover. While many states have passed similar laws, the Carter-Loebsack legislation would ensure the prohibition applies to federally-regulated plans.

The Veterans Early Treatment for Chronic Ailment Resurgence through Examinations Act of 2017 (H.R.1749) or the “VET CARE Act of 2017”, is championed by Rep. Gus Bilirakis (R-FL).  The bill would enable the Secretary of Veterans Affairs to carry out a pilot program to provide outpatient dental services and treatment, and related dental appliances, to eligible veterans, at no cost to such veterans. Under the pilot program, the Secretary would determine whether there is a correlation between veterans receiving such services and treatment, and the veterans suffering fewer complications of chronic ailments, thereby yielding a lower cost of care.


By Patrick Cooney, The Federal Group, Inc.
Legislative Representative, Dental Trade Alliance