Why Dental Coverage Matters: A Tool-Kit


More than 45 million children count on Medicaid or the Children's Health Insurance Program (CHIP) for their medical and dental coverage. Medicaid provides children with a unique set of EPSDT (Early and Periodic Screening, Diagnostic, and Treatment) benefits. This establishes a solid benchmark of care for kids. At the same time, Medicaid allows states the flexibility to develop innovations that are likely to increase the number of children who receive dental services or to deliver services in a more cost-effective manner.

Federal lawmakers renewed CHIP for a full 10 years on February 9, 2018. This historic move came after Congress extended CHIP for 6 years in January, and after letting its federal funding expire on September 30, 2017. Nine million children and more than 300,000 pregnant women count on CHIP every day. 

The Affordable Care Act, sometimes called Obamacare, has enabled many families with incomes too high for Medicaid/CHIP eligibility to secure dental coverage for their kids. It also increased the number of adults with dental coverage. The ACA filled a significant gap that used to exist because many working parents had employers who did not offer dental coverage at all or did not make it available to their employees' children.

Why Dental Coverage Matters

As more and more children have gained dental coverage in recent decades, the rate of untreated tooth decay has fallen among children — even among low-income kids. Recent research adds to the evidence showing how crucial dental coverage is for a child's health.

A recently published study showed that children with public or private dental insurance had more dental appointments and fewer unmet dental needs. Uninsured kids had the fewest dental appointments, and their parents were most likely to report unmet dental health needs due to cost. In other words, coverage opens the door to children receiving the care they need to stay healthy. Because nearly 4 in 10 children are insured dentally through Medicaid or CHIP, any changes to these programs could have a major impact on kids' oral health. 

A Tool-Kit for Health and Children's Advocates

I. Basic Resources to Support Your Advocacy

1. Fast Facts about Oral Health & Dental Coverage: This two-page document shows why oral health is so important, shares the serious consequences of poor oral health and explores the critical need for affordable coverage. Consider sharing this with your members of Congress (House and Senate) and your state legislators.

2. Key Messages about Dental Coverage: This one-pager provides several talking points about why the plan created by the House Republican leadership would be a big step backward for children's oral health, particularly the most disadvantaged kids. These messages will be periodically updated to reflect new information and analyses.

3. Oral Health for Children in Health Reform Discussions: These PowerPoint slides were created by CDHP for a Congressional briefing. Feel free to share these slides with other stakeholder groups in your state or consider incorporating some of these slides' content into your presentations or remarks to policymakers. Slides 6-10 focus on how Medicaid and CHIP coverage reduce kids' unmet dental needs, while giving states sufficient flexibility in shaping their programs.

II. Resources for CHIP Advocacy

After letting federal funds for CHIP expire on September 30, 2017, federal lawmakers ultimately extended the program for a decade on February 9, 2018. This action finally reassures children and pregnant women that they won't lose their coverage, and those who are otherwise eligible may seek enrollment. Visit Teeth Matter, CDHP's blog, for the latest updates on CHIP renewal.

1. Fact Sheet: The Children's Health Insurance Program (CHIP): This three-page document summarizes why CHIP fills what would otherwise be a critical gap in coverage for children.

2. CDHP's Statement Endorsing the KIDS Act: This brief statement (Oct. 2, 2017) by CDHP voices concern about the expiration of federal funding for the CHIP program. The statement expresses support for the KIDS Act to extend CHIP's federal funding for 5 years.

3. Oral Health Community Statement on CHIP: This statement (Oct. 3, 2017), issued by more than 100 organizations that care deeply about oral health, urges Congress to "make the future of the CHIP program an immediate priority." The statement explains that children with CHIP coverage are less likely to have unmet dental needs that uninsured peers.

4. Video: Pediatric Dentist Talks about CHIP's Importance: In this 28-second video, Dr. Jonelle Anamelechi briefly explains why the CHIP program plays a crucial role in helping children maintain good oral health. Dr. Anamelechi is a dentist in New Carrollton, Maryland.

5. Joint Statement about Congress' Failure to Extend CHIP Funding: In this joint statement, eight children's health and medical organizations declare that they are "deeply distressed by Congress' failure to extend funding for the Children's Health Insurance Program (CHIP) by the September 30th deadline." As the statement explains, the deadline "has real implications for real families" because various states "are taking action to modify or end their programs because of continuing uncertainty."

6. Calling Your Members of CongressThis resource provides a sample message you can use to urge your members of Congress to extend federal funding for the CHIP program. This document includes hyperlinks that give you quick access to the contact info for your members of the House and Senate.

7. Writing Emails & Letters to Members of CongressThis document provides tips and sample language you can use to write a letter or email to your members of the U.S. House and U.S. Senate. Links within this document will provide you with the email or mailing address for your representatives.

8. Writing Emails or Letters to Your Governor:  This helpful document provides sample language you can use to send a letter or email to your Governor. Getting Governors involved in crucial to pressing Congress to extend CHIP funding. This document also helps you find your Governor's email or postal address.

9. Calling Your Governor's Office: This document provides sample language you can use to briefly tell someone in your Governor's office why you support the CHIP program and why it's critical that your Governor publicly speak up in support of extending CHIP funding. A hyperlink in the document provides access to the phone number for your Governor's office. 

10. Social media guide: This resource guide offers sample messages to use on Twitter, Facebook and other social media channels to urge Congress to pass a multi-year CHIP extension.

11. Twitter or Facebook Graphic: This graphic can be attached to any Twitter or Facebook message. Using graphics like this can increase social media engagement, as can using related hashtags like #ExtendCHIP or #CHIPworks. For updates and content you can easily share, be sure to follow @Teeth_Matter on Twitter and like @childrensdentalhealth on Facebook.

III. Resources for Medicaid Advocacy

1. Medicaid Caps Would Harm Children and Pregnant WomenThis one-page public statement was issued by CDHP, the American Academy of Pediatrics, March of Dimes and five other organizations that advocate for children's health. As the statement warns, "Over time, capping Medicaid would likely force states to ration care, reduce eligibility levels, reduce benefits for children, or reduce provider reimbursement rates even further — all of which will result in diminished access to care for children and pregnant women."

2. News Release for "Keep Medicaid Strong for Kids": This March 22 news release, issued by CDHP and six other medical/children's advocacy organizations, urged Congress to keep Medicaid strong for children by voting "no" on the proposed American Health Care Act (AHCA). As the release explained, AHCA "would allow states to choose a block grant model, which would eviscerate existing protections afforded to children and pregnant women in the Medicaid program."

IV. Web Banners & Interactive Maps

1. Banners for Social Media & Websites: Two different banners have been created to raise awareness of what's at stake for dental coverage. These banners can be attached to messages posted on Facebook or Twitter.

  • Banner 1 points out why coverage is so crucial, sharing survey data showing that dentally uninsured children are nearly 3 times more likely to go without dental care than kids who are insured.
  • Banner 2 urges the U.S. Senate not to reverse the historic progress our nation has made in raising the percentage of children who have dental coverage. Over a 14-year period, the portion of kids lacking dental insurance plunged by 58%.  

2. Children Enrolled in Medicaid - Interactive Maps: These interactive maps allow people to learn the percentage of Medicaid-enrolled children by county or Congressional District. These excellent maps were created by Georgetown University's Center for Children and Families, an organization with which CDHP is proud to partner.

V. Letters to Congress from Children's and Oral Health Coalitions

1. Public Statement (June 14) on CHIP by the Children's Community: CDHP joined seven other children's health advocates in releasing this public statement about the Children's Health Insurance Program or CHIP. The statement urges Congress "to take immediate action to stabilize CHIP in its current form and enact a five-year extension of CHIP funding." The statement noted that CHIP is a 20-year-old health coverage program that has enjoyed bipartisan support.

2. National Governors Association (NGA) Supports Continued Federal Funding for CHIP: In this May 11th letter to U.S. Senate and House leaders, the NGA urges Congress to "act quickly to provide a five-year extension of funding for the Children’s Health Insurance Program (CHIP), at the current enhanced match, to provide certainty for states and families."

3. Children's Advocates June 12 Letter to U.S. Senator Bill Cassidy: This letter thanks Sen. Cassidy for arguing that a federal health reform plan should pass the "Jimmy Kimmel test." In addition, these seven organizations urge the Senator to apply this test to children's health, "from birth throughout childhood."

4. Dental Community's June 9 Letter to Committee Chairs: This letter — co-signed by CDHP, the American Dental Association and more than 40 other organizations that care deeply about oral health urges the chairmen of key U.S. Senate committees to "protect access to oral health coverage for all Americans." The letter adds: "The Medicaid program's importance to Americans' oral health cannot be overstated." 

5. Children's & Family Advocates' March 22 Letter to Senate and House Leaders (PDF): CDHP was one of more than 100 national organizations, as well as organizations from all 50 states, co-signing this letter urging leaders of Congress to adopt a “do no harm” standard for children as they consider any changes to the nation’s health care system. Today, roughly 95% of U.S. children have health coverage, and none of these organizations want to see that progress reversed.

6. Dental Community's Feb. 27 Letter to U.S. Senate Committee (PDF): This letter was co-signed by 18 oral health organizations and sent in late February to the chairman and ranking member of the Senate Finance Committee. As the Committee explores opportunities to improve the healthcare system, the letter urges it to build recent progress and "fully attend to the oral health needs of Americans as it is a critical but often overlooked component of overall health."

VI. Webinars and Other Resources

1. Webinar — Revisiting oral health advocacy: Social media 101. Recorded on March 6, 2018, this is the second of two webinars by CDHP in partnership with Community Catalyst and FamiliesUSA. Amy Cotton, CDHP policy communications manager, reviews the fundamentals of using social media in an advocacy context and walks through Facebook and Twitter. Melissa Burroughs, FamiliesUSA oral health government affairs advocacy manager, shares examples of successfully incorporating social media into oral health and overall hadvocacy efforts, including by elevating personal stories and storybanking. (For additional training on storybanking for oral health and overall health advocacy, watch a webinar recording, access a PDF of slides, and download a Storybanking Guide provided by Community Catalyst.) To download slides from Social Media 101, click here.  

2. Webinar — Revisiting oral health advocacy: What have we done, what have we learned, and where are we going? Recorded on January 16, 2018, this presentation is the first of two webinars by CDHP in partnership with Community Catalyst and FamiliesUSA. Debbie Vishnevsky, CDHP policy analyst, reviews major policy issues that arose in 2017 and identifies key concerns for the coming year. Helen Hendrickson, senior state advocacy manager at Community Catalyst, presented findings on successful strategies, wins, and lessons learned from interview with state advocates to help inform our actions moving forward. To review a PDF of webinar slides, click here.

3. Webinar – Renewing The Children’s Health Insurance Program (CHIP): Recorded on September 7, 2017 this webinar takes a closer look at the CHIP program with a focus on state concerns about the future of this program, the implications for oral health, and an update on what is happening in Congress. CDHP’s Deborah Vishnevsky, policy analyst, and policy consultant Libby Mullin were joined by Maureen Hensley-Quinn, Senior Program Director at the National Academy for State Health Policy. The presentation ends with advice on how to best engage policymakers. For a PDF of the webinar slidesclick here.

4Webinar – How the American Health Care Act (AHCA) Would Impact Children: These slides are from a June 8, 2017 webinar that focused on the AHCA bill that the House passed as a replacement for the Affordable Care Act. The presenters were: a) Aimee Ossman, vice president of policy analysis and implementation at the Children's Hospital Association; and b) Lisa Shapiro, vice president of health policy at First Focus. Click on the "Webinar" header to play or download a recording of this webinar. For a PDF of the webinar slides, click here.

5. Webinar  Medicaid Waivers and Children's Oral Health (PDF): These slides are from a May 9, 2017 webinar that focused on Medicaid waivers and their impact on children's oral health. Access a recording of the webinar here. The presenters were Sara Rosenbaum of the Milken Institute School of Public Health (George Washington University) and Peter Damiano of the University of Iowa Public Policy Center.

6. Webinar – The Uncertain Future of Medicaid and Children's Oral Health (PDF): Recorded on April 5, 2017, this webinar was co-presented by CDHP and Community Catalyst. The webinar reviewed why the House Republican leadership's plan was so troubling and also explored the crucial role that grassroots advocacy played in defeating the plan. Click on the "Webinar" header to access the slides, and a recording of the webinar is available here.

7. Webinar – The Uncertain Future of Medicaid and CHIP: Recorded on March 9, 2017 this 53-minute webinar provides an update about proposals to reshape Medicaid and explores the future of the Children’s Health Insurance Program. CDHP’s Colin Reusch, senior policy analyst, and policy consultant Libby Mullin were joined by Genevieve Kenney, who is co-director of the Health Policy Center at the Urban Institute. The webinar examines what is at stake amid the health reform debate in Congress and how oral health advocates can be an effective voice. A PDF of the webinar's slides is available here.

8. Statement from Children's Organizations Opposing the Graham-Cassidy Bill: This statement issued by nine leading children's and family health organizations urges Congress to reject the Graham-Cassidy health care bill. As the statement explains, this proposal would repeal the Affordable Care Act and impose "deep and growing cuts" in health care funding for states, which, in turn, would probably lead to millions of children and adults losing coverage. Eight of these children's organizations sponsored this print ad in Roll Call and The Hill urging Senators to oppose the Graham-Cassidy bill. 

9. Fact Sheet: The Impact of the Better Care Reconciliation Act (BCRA): This three-page document summarizes CDHP's concern with the Senate's BCRA bill. In addition to replacing the Affordable Care Act, BCRA makes deep cuts in Medicaid and gives states the ability to waive or exclude pediatric dental benefits or other services included in the Affordable Care Act's Essential Health Benefits. 

10. Fact Sheet: The Impact of the American Health Care Act (AHCA)This two-pager summarizes how the bill known as AHCA would negatively impact dental coverage and access for children and families.

10. The Impact of Senator Ted Cruz's AmendmentSenator Cruz (R-Texas) has drafted an amendment that may be added to the BCRA bill. The Kaiser Family Foundation provides this analysis of the amendment's likely impact on coverage and affordability.

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