President's budget request risks oral health of children and families.

By: Colin Reusch

Just days after President Trump signed a bill extending funds for the Children’s Health Insurance Program (CHIP) for 10 years, the White House released the President’s budget request for 2019. This document requires Congressional action to have a concrete impact, but the Children’s Dental Health Project is compelled to respond as it signals the administration’s priorities and provides Congress with direction for its legislative agenda. Despite widespread bipartisan support for children’s health and dental coverage, as evidenced by the historic CHIP agreement, the President’s budget blueprint would erode this progress. 

Several aspects of the proposal would threaten coverage and access to care for millions of children and families, while cutting funds for important programs that support America’s oral health. 

Perhaps the most concerning component is a revival of proposals to cap Medicaid funding to states. The budget offers policies similar to those outlined in bills aimed at repealing and replacing the Affordable Care Act, like Graham-Cassidy or the ill-fated American Health Care Act. In fact, the President’s budget directly references Graham-Cassidy as the model for slashing Medicaid by $1.4 trillion over 10 years, in addition to jeopardizing subsidies that help people afford to purchase private health insurance. Last year, the Congressional Budget Office estimated that this measure would result in millions of Americans losing health and dental coverage.

Given the far-reaching consequences of tooth decay on children and adults, particularly for families struggling to make ends meet, we must remind policymakers to prioritize oral health.

The President’s budget calls on Congress to double down on policies that would weaken state Medicaid programs, undermining their ability to address children’s health and dental needs as required by law. On top of that, its dramatic cuts to key public health programs would shrink state budgets. When states are faced with difficult decisions, dental coverage for adults and pregnant women are often among the first items on the chopping block. Research tells us that would ultimately harm children.

In addition to threatening oral health coverage in Medicaid, the President’s budget seems to downgrade oral health as a priority overall. It recommends reducing funding for research, provider training, and public health initiatives that were designed to bolster coverage and ensure states can serve their most vulnerable populations. Troubling program cuts include:

Program   Funding change   (less/more,
— / +)
Centers for Disease Control and Prevention’s Division of Oral Health  — $878,000
National Institute for Dental and Craniofacial Research  — $10 million
Health Resources and Services Administration’s (HRSA) health workforce training in oral health and primary care  — $75 million (eliminated)
HRSA Maternal and Child Health Block Grant  — $10 million

Given the far-reaching consequences of tooth decay on children and adults, particularly for families struggling to make ends meet, we must remind policymakers to prioritize oral health. Looking for ways to spend elsewhere at the expense of working class families would only take us backwards. As a country, we should build on the progress we’ve made in improving the oral health and economic wellbeing of children and families through programs like Medicaid and CHIP. CDHP will continue to monitor federal action and urge lawmakers to steer clear of proposals that would risk our children’s future.

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of new military recruits couldn't be deployed because of dental problems.
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