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Advocates say losing dental and vision from Alliance/Healthy DC will have cascading harms; agencies seek cost estimates
Summary
Advocates, clinicians and dental leaders told the committee that removing adult dental and vision from coverage will increase emergency care, worsen chronic disease control and raise medical debt; Legal Aid and others provided an estimate (~$5.1M) for adding adult dental to Healthy DC and urged the council to consider a short‑term supplement.
A recurring theme at the roundtable was adult dental and vision coverage, which advocates and clinicians described as essential to preventing downstream medical emergencies and preserving patients’ ability to work. Nancy Ban of Mary’s Center said 40% of Alliance participants with diabetes received a dental visit in 2024 and tied oral health to improved A1C control.
Kurt Gallagher of the DC Dental Society cautioned that many dental emergencies require procedures beyond antibiotics and said community programs that triage and divert dental emergencies have treated hundreds of patients in pilot runs, but warned the community network alone could not absorb thousands of newly uninsured adults. Legal Aid’s Andrew Patterson testified that adding adult dental to Healthy DC was estimated at around $5.1 million annually, a small share of the District’s budget if policymakers opted to restore benefits.
Agencies acknowledged the question but said Healthy DC’s benefit design flows from federal and actuarial constraints; Kaufmann said dental and vision were excluded in the HBX benefit package in the current design but that the program has automatic triggers if Congress restored premium tax credits. Committee members asked DHCF and HBX for a current, line‑by‑line cost for restoring adult dental and vision and said they would consider contingency funding depending on the CFO’s revenue certification.
