February 1, 2023

Johnny Carson once said, "Happiness is your dentist telling you it won’t hurt and then having him catch his hand in the drill." With the medical device tax issued under Obamacare, it could also be said, "Happiness is the government telling you new taxes won’t make dental care more expensive and then having them catch their hand in the drill."

Obamacare, also known as the Affordable Care Act, was signed into law on March 23, 2010, implementing sweeping reforms to our health care system. One of the main goals of the Affordable Care Act (ACA) is to make health care more readily available to those who have had little or no access to it before. Those on Medicare now have free access to key preventative services, and it is anticipated that every American will have access to affordable health care options by 2014. The ACA will require insurance companies to offer a package of ten essential benefits to customers, including emergency services, maternity and newborn care, and pediatric services, among others. But while the ACA requires insurers to offer dental care for children, it does not require insurers to offer dental care to the general public.

It is estimated that in 2014, 5.3 million children will gain access to dental coverage as a result of the Affordable Care Act. As any dentist will tell you, the best time to start good oral hygiene is early childhood–the younger, the better. For this reason, more children having access to dental care will only be beneficial, in terms of preventing gum disease and tooth decay. Families who do not have employer-provided dental coverage will be able to get dental coverage either through a small group plan or an individual plan. Each state will be required to set up exchanges where customers can shop for dental coverage. In these exchanges, insurance companies will compete to provide mandatory benefits at an affordable price. It is still unclear, however, what this coverage will look like from state to state, and how this coverage will compare with private dental insurance. It is also unclear which dentists will accept which coverage.

The ACA will offer other potential benefits, including setting aside funding for grants to train additional dental hygienists and dental therapists, and providing loan repayment programs for dentists who choose to work in underserved areas. The ACA will also require the Centers of Disease Control and Prevention (CDC), to establish a five-year oral health care campaign, with the goal of educating the public on good oral health practices.

Despite these benefits, however, it is the potential rise in cost of dental care that has many in the industry concerned. The Organized Dentistry Coalition estimates that the Affordable Care Act will cause dental health care to rise by as much as $160 million annually. The reason for this increase is the 2.3 percent tax on medical devices, the tax proposed to help fund Obamacare.

According to the FDA, a dental device is any device "used to maintain dental health and treat dental problems." This includes crowns, bridges, dentures, implants, mouth guards, and material for fillings. The medical device tax went into effect January 1, 2013. The fear is that the cost from this tax will pass from manufacturers of medical devices to suppliers, from suppliers to dental practices, and eventually to customers. If dental practices are forced to raise the cost of their services as a result of this tax, dental care will become even more expensive for customers. Dr. John Reitz said that issuing a tax on medical devices is like "trying to pay for dental care by placing a tax on dental care."

At a hearing held on June 4, 2013, Representative Larry Bucshon (R-IN) called on the Obama Administration to repeal the medical device tax. Indiana is home to several medical device companies, which add $10 billion to the state’s economy annually. Rep Bucshon pointed out that some medical device companies have cancelled plans to expand, citing the 2.3 percent tax levied by Obamacare.

Senator Orrin Hatch (R-UT) called the medical device tax "a drain on innovation, on job creation and on our ability to provide ground breaking medical technologies to patients." Senator Hatch co-sponsored a measure with Amy Klobuchar (D-Minn) that would repeal the tax. The measure passed both the Senate and the House, showing overwhelming bipartisan support. However, Kathleen Sebelius, Health and Human Services Secretary, has said that the Obama administration has no intention of repealing the tax.

So while the Affordable Care Act will provide dental health benefits to millions of children who would not have access otherwise, it will not provide mandatory dental coverage for adults. And though the main goal of the ACA is to make healthcare more readily available for all Americans, the 2.3 percent tax on medical devices will potentially make dental care more expensive in the end.