Sen. Casey holds hearing in Wilkes-Barre to address Medicare expansion

WILKES-BARRE — U.S. Sen. Bob Casey on Monday said the time is now to expand Medicare to cover “whole person care” — eyes, ears and teeth — to assure senior citizens can get the care they need to retain a high quality of life.

Casey, D-Scranton, convened a field hearing of the Senate Special Committee on Aging — “Eyes, Ears and Teeth: Expanding Medicare to Cover Whole Person Care” — at the Luzerne County Courthouse to take testimony from a panel of experts on the topic.

The hearing examined the need to strengthen and expand Medicare to include coverage for vision, dental and hearing services.

The panel members were:

• Joanne Grossi, president, AARP Pennsylvania of Philadelphia.

• Joseph Hollander, chief executive officer, Scranton Primary Health.

• Robin Stelly, statewide organizer, Pennsylvania Health Access Network, Philadelphia.

• Kelly Ranieli, executive director, Volunteers in Medicine, Wilkes-Barre.

Casey began the hearing by saying there is a pressing need to expand coverage of eyes, ears and teeth for seniors, especially following 18 months of the COVID-19 pandemic.

“We have seen the greatest health crisis of our lifetime,” Casey said. “Families have faced many challenges.”

Casey noted that Luzerne County received $196 million through the American rescue Plan.

The state’s senior senator said prescription drug costs must be lowered, health care premiums must be affordable and there must be a bigger investment in children and in caregivers.

“Poor access to basic care poses a serious health risk to older Americans,” said Chairman Casey. “Some 15 percent of older adults have lost all of their teeth due to untreated dental disease. Vision loss is associated with an increased risk of falls and mobility limitations, and hearing loss can lead to both social isolation and cognitive decline. There is no excuse for that in the most powerful county in the world. That’s why I introduced a bill to cover dental, vision and hearing in Medicare and strengthen coverage in Medicaid.”

In addition to highlighting his Medicare and Medicaid Dental, Vision and Hearing Benefit Act (S. 2618), Casey also advocated for allowing Medicare to use its purchasing power to bring down the cost of prescription drugs. These policies are being considered in the Senate’s budget reconciliation package currently being negotiated.

The panel of experts and Casey stressed that the key issues not only cause physical problems for seniors, but also result in the loss of dignity, often resulting in social isolation and increased stress.

“These issues should not force seniors to decide between buying groceries or medication,” Casey said. “And no one should have to deplete their life savings to pay for dental care. We must do better.”

Testimony highlights

Ranieli said Volunteers in Medicine is a community-based nonprofit organization established to provide primary and preventive medical, dental and behavioral health services to the working uninsured and under-insured populations in Northeastern Pennsylvania.

She said in March of 2021, there were 703,300 uninsured adults, or approximately 7% in Pennsylvania. It is estimated that almost three times that amount have no dental insurance. Higher uninsured rates reported were more among people of color, small business workers, people with low income and young adults.

“Our goal is to get them out of pain, educate on oral hygiene and on a bi-annual cleaning schedule,” Raineli said. “Due to the complexity of treatments required, we have a waiting list of those desperately needing services in the dental clinic that exceed 350 people.”

Raineli said the VIM clinic offers a unique health care model that benefits the entire community.

“It is important to understand that in order to heal the entire well-being, medical, dental and behavioral health care needs to be provided especially to the low income, under-served populations. Everyone benefits from a healthy community,” she said.

Grossi, of AARP, said the lack of a dental benefit worsens the problem of social isolation.

“One respected study has found that the impact of prolonged social isolation is equivalent to smoking 15 cigarettes a day,” Grossi said. “So we have to ask, why continue a policy that ignores oral health, that leaves so many older adults with tooth loss, that makes them embarrassed about their smile, and makes it harder for them to communicate? We can help prevent the social isolation that comes with losing your self-confidence and ability to connect with family and loved ones.”

Simply put, Grossi said Medicare should cover dental care, vision care — including eyeglasses — and hearing care, including hearing aids.

“Medicare beneficiaries want, need and deserve these services and are often surprised when they learn Medicare doesn’t cover them,” she said.

Stelly, of the Pennsylvania Health Access Network, said the importance of dental, vision and hearing to the health of older adults is well noted in the medical literature.

“The lack of dental care and poor dentition is known to increase heart disease and frailty of older adults. Poor vision and hearing is highly correlated with loneliness, depression and injuries such as falls,” Stelly said a client told her. “Few older adults can afford the out of pocket costs for both glasses and hearing aids.”

Hollander, of Scranton Primary Health, said, “I cannot stress to you how important the link is between good oral health and good physical health. Common sense tells us if your diet is severely limited because you are unable to chew your food and eat a healthy diet, you can’t get the nutrients and nourishment you need. For some reason this is stressed to us, over and over when we are young, but ignored when it comes time to care for our seniors.”