The Maine House and Senate have given preliminary approval to a bill expanding dental coverage under MaineCare, a move that would provide much-needed services to more than 200,000 residents.

Maine currently is one of just 10 states that covers dental care only when it becomes an emergency. The bill that won bipartisan support in the House and Senate would allow people 21 or older who are on MaineCare – the state’s Medicaid program – to receive preventive, diagnostic and restorative care.

The bill passed the House late Wednesday on a unanimous, “under the hammer” vote and then also received unanimous support in the Senate on Thursday. The measure requires additional votes in both chambers and, because it would carry an estimated $1.1 million price tag in the current budget cycle, would have to be funded by the Legislature’s Appropriations and Financial Affairs Committee.

If given final approval and signed or allowed to become law by Gov. Janet Mills, comprehensive dental coverage would begin for MaineCare residents by April 2022.

“This is a landmark day for the people of Maine,” House Speaker Ryan Fecteau, D-Biddeford, the bill’s sponsor, said in a statement. “The need for dental care impacts every single community in our state. Maine’s system has forced vulnerable people to use the emergency room when their teeth can’t be salvaged, which ends up costing Maine people their dignity and health. Ultimately, it has also cost our state economically, and that’s about to change.”

The bill, L.D. 996 would extend preventive dental coverage to more than 200,000 lower-income Maine residents currently on MaineCare. The measure received broad support from Maine’s dental and medical communities.

“It’s important to note that this problem goes well beyond cavities, pain, oral infections and lost teeth,” said Dr. Barbara Covey, an emergency department physician who serves on the board of nonprofit Waterville Community Dental Center. “I have seen hundreds of diabetics whose management and control are worsened by chronic dental disease, dental infections so advanced that they have required ICU management for generalized sepsis and airway obstruction, and life-threatening lung infections associated with chronic dental disease.”

“Oral disease does not discriminate based on age, race, sexuality, or socioeconomic strata. Every one of us is at risk of oral disease, but those who have the least are at highest risk,” added Dr. Wendy Alpaugh, a dentist from Stonington. “Barriers to dental care are formidable for those without the means to be seen by a dental professional. Leveling the playing field is a win for society.”

A 2012 task force that examined potential changes to MaineCare estimated that the state pays $17 million a year for emergency room visits for dental care. A fiscal note attached to L.D. 996 estimates that providing preventive and restorative dental care would cost the state $1.1 million during the first, partial fiscal year that benefits begin and then between $4.2 million and $6.5 million in subsequent years while leveraging between $13.2 million and $17.2 million in federal funds annually.

The measure had broad, bipartisan support, which hasn’t always been the case for bills that seek to expand MaineCare benefits. Republicans for years have fought several attempts to expand access to MaineCare.

“Looking at the downstream benefits from this bill, I see the possibility of those investments that will occur in the short-term leading to significant dividends that will be achieved here in the state of Maine,” said Rep. Sawin Millett, R-Waterford, a co-sponsor. “This is a sequential and methodological approach to implementing an ambitious undertaking. This investment, on the human side of the equation as well as the Maine economic side, will provide benefits that are predictable and that will have a high cost-benefit ratio.”

During a public hearing on the bill, several people spoke about economic hardships created by lack of dental coverage. Kayla Kalel of Bangor, a student at the University of Maine Augusta, said she had to pay out-of-pocket to save her teeth after having extensive dental problems. She said she avoided student debt up until last year, but had to take out $6,000 in student loans the past three semesters in order to have enough money to pay for her dental care and school.

“It’s just really sad I had to put myself in debt for this,” Kalel said. “It adds up very quick.”

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