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On March 3, Sens. Debbie Stabenow (D-MI), Cory Booker (D-NJ), and Ben Cardin (D-MD) introduced the Oral Health for Moms Act, which would expand oral health coverage in Medicaid for those who are pregnant or postpartum. The bill would also expand funding for dental services at Federally Qualified Heath Centers and make oral health coverage during pregnancy and postpartum an Essential Health Benefit (EHB). NADP provided recommendations related to the EHB provision and will continue to engage with bill sponsors moving forward. The bill will not be considered as part of the COVID relief package currently moving in the Senate.
Summary
- Requires coverage of oral health care for pregnant and postpartum women enrolled in Medicaid and the Children’s Health Insurance Program, including:
- Diagnostic and preventative care
- Basic Services including fillings, extractions
- Major dental services including root canals, crowns, and dentures
- Emergency dental care
- “Other necessary services related to dental and oral health as defined by the Secretary”
- Provides a 100% Federal Medical Assistance Percentages (FMAP) increase for services rendered under the bill’s expansion of dental coverage and establishes a maintenance of effort requirement on the funding.
- Directs the Secretary to establish quality measures for maternal oral health, focusing on utilization, availability, and screening.
- Measures should align with the existing Medicaid core quality measures.
- Includes oral health services for pregnant and postpartum women as an essential health benefit in the health insurance marketplaces.
- The new benefit would conform to existing requirements to offer dental on Exchanges. For example, a medical plan would not have to embed the pregnancy/postpartum benefit if there is an SADP offering the coverage on the exchange. NADP successfully advocated for changes to earlier drafts that would have required medical plans to embed the pregnancy/postpartum benefit.
- Provides grants to Federally Qualified Health Centers to provide dental services.
- Creates an oral health initiative through the Indian Health Service to improve oral health and address barriers to care for American Indian and Alaskan Native populations.
- Requires a perinatal oral health outreach and education program to provide interactive oral health education, information on oral health coverage, and refer pregnant individuals to oral health services.
- Provides training grants to improve availability of care and its outcomes and to integrate dental care into maternal health settings.
NADP will continue to monitor the bill’s progress and work with congressional offices on its development. For more information, contact Sr. Government Relations Analyst Owen Urech.
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