Lack of dental coverage traps PA residents in medical and credit debt

The lack of dental care can cost Pennsylvania residents thousands of dollars during an emergency. Over a quarter of Pennsylvanians lack dental coverage and face higher medical bills. 

Out of pocket dental costs can be some of the most prohibitive medical expenses that prevent people seeking the care that they need, and that problem is exacerbated when more than 25% of Pennsylvanians lack dental coverage.   

“Across all aspects of healthcare, dental services present some of the highest cost barriers for people,” Colin Reusch, Director of Policy with Community Catalyst, said in an interview. 

“In fact, when you look at the share of out-of-pocket costs broken down by healthcare category, dental care is just about at the top of the list, outpacing even prescription drugs in terms of the out-of-pocket burden that people face for accessing that care.”

CareQuest Institute for Oral Health, which advocates for accessible and equitable dental care, found that 67% of Pennsylvanians visited a dentist in 2023, while 7% of residents skipped visiting a dentist while having an oral health problem due to costs. 

The report stated that 3% of Pennsylvanians visited a hospital emergency department – rather than a dental office – for dental care during that time. Charges from those visits reached as much as $584 million. 

In Pennsylvania, it could cost a patient without dental coverage up to $200 for a yearly cleaning and x-ray and the prices only increase from there. A root canal can cost between $1,100 and $1,300 depending on the tooth, and a crown can cost an extra $1,000. 

“One consequence of that is that folks end up seeking care for dental problems and dental emergencies in the hospital emergency department, which can come with significant costs both to the individual and to the healthcare system and the taxpayer,” Reusch said. 

In order to pay down the high costs of dental care, people can find themselves ensnared in credit card debt via deferred interest medical and dental credit cards. 

According to Community Catalyst, these cards offer patients 0% interest during a promotional period, but can get stuck paying high interest fees if they fall behind their payments.  

One way Pennsylvania can combat high dental costs and the lack of dental coverage is to place dental care back in Medicaid coverage, which was removed in 2011. 

NPR reported in 2012 that former Republican Gov. Tom Corbett cut dental coverage for 2 million adult Medicaid patients to basic dental care, saving the Department of Welfare $42 million. The cuts eliminated coverage for root canals and periodontal disease work and limited the number of dentures a patient can receive.  

A bipartisan bill passed the Democratic controlled Pennsylvania House to restore Medicaid coverage last December, but failed to make it through the Republican-controlled Senate. 

Advocates will have to start the legislative process all over again come January because of the legislative session coming to a close. 

“Over the past year, there’s been an ongoing effort in the legislature to restore that full scope of benefits,” Reusch said about the 2011 Medicaid cuts. 

“For folks who need more than routine care, they may find that their dental coverage under Medicaid simply doesn’t cover the services that they need and they’re left without any real recourse to afford those services.”