Legislators last session decided against funding a dental benefit in MaineCare, the state’s Medicaid program, opting instead to form a working group to study the issue.

To be sure, there are a lot of complex issues swirling around the creation of a new Medicaid benefit, and the group’s findings could help provide a clear picture of the costs and benefits around a MaineCare dental plan. It is imperative, for instance, that reimbursement rates for dentists in the MaineCare system be sufficient to attract providers.

PORTLAND, ME - NOVEMBER 1: Stephanie Beeckel, left, and Chris Priest perform a dental cleaning for Mary Rena at the Oral Health Center at the University of New England in Portland on Friday, November 2, 2018. The university participated in the Dentists Who Care for ME on Friday, an event where dentists in Maine provide free dental care for people who can't afford regular dental care or who don't have insurance. Beeckel is a third year dental student and Priest a first year dental student at UNE. (Staff photo by Gregory Rec/Staff Photographer) Gregory Rec/Staff Photographer

But the lack of dental care for low-income residents is not a new issue, and the effects are clear. Low-income adults who qualify for MaineCare for medical coverage typically cannot afford dental coverage and thus regular dental visits. For those in rural areas, providers are often far away, only adding to the cost.

Without regular dental care, many of these Mainers will develop tooth decay and gum disease that eventually require expensive procedures, leaving them with fewer teeth and higher debt. They’ll have trouble with their diet, and possibly with heart and cardiovascular disease. Many say they feel embarrassed in public or during job interviews.

They end up like Sass Linnekan of Winthrop, who testified earlier this year in front of a legislative committee. After years in poverty, Linnekan now has almost $6,000 in credit card debt after trying to fix the effects of years of untreated chronic infections.

“As a result, my bills are now so high from this that l am facing having to file for bankruptcy,” Linnekan testified. “I’ve pulled myself from poverty into the working class, and these are the real and very lasting impacts to not having access to dental care.”

Only if things get too bad, like when poor dental hygiene causes a painful abscess and a trip to the emergency room, will MaineCare pay.

It is a backward system that leaves people in bad shape, with mounting debt and demoralized by bad teeth. They go through life in poor health and often in need of expensive emergency care, when they would have been fine with regular access to low-cost preventative measures.

Medicaid lets states decide whether to add dental coverage, and Maine is one of 12 that offers coverage only for emergencies, though three states offer no dental coverage whatsoever.

Thirty-five states, plus D.C. offer something more than emergency coverage, while 19 states and D.C. offer extensive dental services, such as annual cleanings and checkups.

A bill that would have expanded dental benefits under MaineCare was left unfunded; the fiscal note called for $6.5 million from the state, which would have leveraged an additional $17.2 million in federal funds. It’s not exactly a budget buster.

Instead, the working group was created. Maine has looked at this problem before and established that expanding the MaineCare dental benefit is a big part of the solution.

Advocates say they will try to get funding for the bill next session, and that the political realities are in their favor.

Legislators should fund the bill, and make sure that dental care is treated the same as other kinds of health care.