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Plan would improve reserve, Guard dental care

The Senate Armed Services Committee is proposing two major changes to expand dental care for National Guard and reserve members.

First, the committee would allow dental co-payments to be waived in time of national emergency for Guard and reserve members enrolled in the Tricare Dental Program.

Second, it would provide free dental care to members of the Air Force, Navy and Marine Corps reserve components who are scheduled for deployment — a benefit currently available only to the Army Reserve and Army National Guard.

Both provisions are included in S 3100, the Senate version of the 2009 defense authorization bill approved by the committee in May. The House version of the bill does not include similar provisions, leaving the fate of the proposals to future negotiations on a final compromise bill.

The nonpartisan Congressional Budget Office, the arm of Congress responsible for estimating the cost of pending legislation, says the two Senate provisions would cost about $32 million in 2009 and $202 million over five years.

About 60,000 reservists are enrolled in the Tricare Dental Plan, which requires a monthly premium of $11.58 for an individual drilling reservist and a maximum premium of $83.95 for a family. There are no co-payments for preventive care, but reservists must pay for other dental treatment, such as 50 percent of orthodontic care.

Budget analysts predict there would be a 50 percent increase in use of dental benefits if co-payments were waived, with the average reservist receiving about $340 a year in services.

Budget analysts also estimate that 8,000 Air Force, Navy and Marine Corps personnel would get additional dental care if no-cost, post-deployment restorative services were provided.

The estimated average cost of the care, based on the existing Army plan, would be about $1,200 per person, according to the budget office. This is higher than the average cost estimated for waiving co-payments for people enrolled in the dental insurance plan because mandatory screening would identify more people who needed greater dental services.

Providing restorative dental care for reservists after deployment is one of the top health care priorities of the Reserve Officers Association.

“Dental hygiene is not a priority on the battlefield, and many reserve and Guard [members] are being discharged with dental readiness levels much lower than when they were first recalled,” said Marshall Hanson, ROA’s director of legislation.

Dental problems among reservists also have been a major factor in their availability for deployment.

While existing dental insurance has been helpful, Hanson said cost has been an issue. “Premium increases to the individual reservist have caused some junior members to forgo coverage,” Hanson told the Senate Appropriations defense subcommittee June 4.

Hanson also praised the fact that the House version of the defense policy bill, while it does not include the co-payment waiver or pre- and post-deployment dental care for all reservists, does include an increase in funding for reserve dental care that is equally important.

In its report on the defense bill, the Senate Armed Services Committee said it is worried about dental readiness because of a Defense Department report that said 57 percent of Army National Guard and 50 percent of Army Reserve personnel had such serious dental problems in the first quarter of fiscal 2008 that they might not meet deployment standards.

The other services had similar problems, though not as large, with 26 percent of the Coast Guard Reserve, 22 percent of the Marine Corps Reserve, 15 percent of the Air Force Reserve, 11 percent of the Air National Guard and 10 percent of the Navy Reserve having serious dental problems.