WASHINGTON, D.C. — U.S. Senator Ben Cardin (D-MD), Chair of the Finance Subcommittee on Health Care, held the first hearing of the 118th Congress called “Oral Health: Identifying and Addressing Health Disparities,” today March 29,, 2023.
Senator Cardin delivered the following opening remarks:
“Let me welcome everyone to the first meeting on the subcommittee on health, of the Senate Finance Committee of this Congress. I want to thank Senator Wyden and Senator Crapo for their cooperation in the establishment of the subcommittee, and our ability to hold hearings.
Senator Danes, I want to thank you for your help and cooperation. I look forward to working with you. We have, obviously, a very important agenda, and I hope that the subcommittee will be able to do some oversight as to some of the issues that are pretty pressing in our healthcare system, during this Congress. I look forward to working with you, and I am very pleased that Senator Stabenow is here. Senator Stabenow has been one of the great leaders on healthcare in the United States Senate, and she served with great distinction as chair of this subcommittee. So, I thank her for her help. I know of no subject that she has been more active in than on oral healthcare. She’s been one of our great leaders in this area of oral healthcare.
So, today’s subject is the oral healthcare crisis: the need to address disparities. Disparities in our healthcare system are well documented. And the impact it has in regards to vulnerable communities. With the passage of the Affordable Care Act, we elevated the Institute for Minority Health and Health Disparities, as a full institute under the NIH, and they have documented the disparities based upon income, lower-income communities do not have the same healthcare providers in their communities as we see in other communities. They’ve documented it in rural American where again there is not as any healthcare providers, we’ve documented disparities based on race and ethnicity, because again, there are not as many providers in regards to the workforce. So, we have documented a lot of the reasons for disparities in our healthcare system, and it is very prevalent, the disparities, as it relates to oral healthcare.
It really came home to me, when I was first elected to the United States Senate in 2007, many have heard me talk about Deamonte Driver, but I will mention him one more time. Deamonte Driver was a 12-year-old, who lived in Prince George’s County Maryland, about 7 miles from here. He had a tooth problem. His mom tried to get him help but could not find a dentist to take care of his needs. She tried several times but was unable to get any help. She fell through the cracks; she wasn’t in the Medicaid system at the time, there were some eligibility issues, she didn’t have any reimbursement. Deamonte ultimately became very sick, and was rushed to the hospital, had an impacted tooth, he went through two operations, and what would have initially cost $80 for a tooth extraction, ended up costing hundreds-of-thousands of dollars and tragically Deamonte Driver lost his life. So, that really struck home. A person in my community, that I represented, that we could have that kind of outcome. It led to some changes in healthcare policy, working with Senator Stabenow, working with my dear friend Elijah Cummings in the House, we were able to extend pediatric dental, under both the CHIP program and the Affordable Care program, so we were able to make some progress, but there are still maybe gaps today.
Oral health is integral to over well health and well-being. It can make worse an underlying health condition, impacting overall healthcare cost. It can impact a person’s ability to get a job and be well enough to work. It impacts a person’s ability to go to school, impacting the local and national economy. It can impact a person’s confidence and ability to enjoy life, or communicate effectively, affecting communities and overall society. Despite the importance of oral health, millions of people in the United States are not getting the care they need.
Former US Surgeon General David Satcher said more than 20 years ago that “you cannot be healthy without oral health.” Certainly, we have made progress in improving oral health for children since then, especially for vulnerable children. But for working-age adults and seniors, disparities in oral health outcomes and in access to dental care have widened by income and race. Treating dental care as essential in US health policy—for all ages, not just children—is the only way to address these disparities.
The oral health crisis is costly, and taxpayers are paying for it. Through worse outcomes for people with diabetes or heart disease, worse pregnancy outcomes, and through emergency room visits. We are paying more in our healthcare system, as a result of these disparities. One study found that the U.S. could save $22.8 billion annually by improving oral health care.
This is not a partisan issue. During the Trump administration, the U.S. Surgeon General and NIH began working on the report that became “Oral Health in America: Advances and Challenges,” which was released by the Biden administration in 2021. This was a follow up to the landmark report from 2000, “Oral Health in America: A Report of the Surgeon General,” which provided a comprehensive look at the importance of oral health and the disparities in the United States.
I have been pleased to work with the Biden administration to advance a number of oral health priorities, including the historic appointment of Dr. Natalia Chalmers to be the Centers for Medicare and Medicaid Services’ Chief Dental Officer. That position lay vacant for many years, we finally got it filled, and we are very pleased that we have that position, in order to put a focus within HHS on oral healthcare.
And at the beginning of this year, Maryland Medicaid began covering adults. However, sixteen percent of Maryland residents over 65 years of age and older – approximately 626,000 people in my State. And more than 70% of seniors in Maryland do not have dental insurance. We have gaps that we need to deal with.
To echo Former U.S. Surgeon General C. Everett Koop, “there is no health without oral health.” Adequate access to oral health is essential to preventing tragedies like the passing of Deamonte Driver from ever happening again. I hope we can work together to try to narrow the disparity gaps that we have and find ways we can deal with the healthcare crisis.”
