EDITORIAL: Congressional health reform must include dental care

May 21--Health care has become a dominant -- perhaps THE dominant -- issue of the past decade in the United States. The Affordable Care Act, which President Barack Obama signed into law in 2010, was labeled Obama's signature legislation; it was also the signature issue that Republicans used to hammer Democrats and regain control of Congress.

Now congressional Republicans are grappling with the issue. Considerable arm-twisting brought passage of the American Health Care Act, which skimmed through the House of Representatives but faces a long, hard look in the Senate. One facet that requires a second look across the board is dental care.

The ACA offers limited dental coverage -- it is required for children age 18 or younger but not for adults. The expansion of Medicaid did add coverage for about 5 million adults nationwide, but that coverage -- already inadequate -- is in jeopardy under the House-passed bill. As senators consider what likely will be their own health care bill, they need to figure out how dental care fits in.

A Washington Post story that was published a week ago in the Yakima Herald-Republic spelled out the divide of haves and have-nots for those with access to dental care.

For many dental problems, prevention is the cure, but cost concerns prompt millions of Americans to skip routine checkups until a serious problem occurs -- at which time the patients head to charity clinics or hospital emergency rooms. By then, it can be too late to save the afflicted teeth; according to the Post, almost 20 percent of Americans past age 65 have lost all their natural teeth, which is a sobering figure.

Emergency room visits for dental problems not only raise overall health costs, they also have aggravated the nationwide opioid-addiction epidemic. In 2016, more than 2 million Americans made dental-related ER trips at an estimated cost of $1.6 billion.

Teeth appearance can affect job prospects and social standing -- and amid rising income inequality in the U.S., some people can afford thousands of dollars for cosmetic dental work while others can't even afford to get crowns, root canals or cavities filled. This can further fuel resentment among those who feel left behind in today's economy.

Appearances can be important, as is the satisfaction of enjoying a hearty meal, but the dental care crisis goes far beyond the cosmetic. A mouthful of crumbling teeth -- or, as noted above, no original teeth -- impairs the essential function of bodily nutrition.

The Senate must include -- and the House must sign onto -- dental care in any bill that they send it to President Donald Trump. We've discovered that health care reform comes at a cost, but that must be weighed against the price of doing nothing to alleviate the financial and physical pain of millions of Americans who suffer a mouthful of hurt under the current system.

--Members of the Yakima Herald-Republic editorial board are Bob Crider and Frank Purdy.

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