Steve Rosenblum has been making crafts with inlaid wood for decades, earning a living with the intricate designs, but not enough to pay for dental care.
"I've had dental insurance and taken care of my teeth all of my life, until recently when I can't really afford to do it," Rosenblum said.
He's self-employed, so he buys regular health insurance on his own. But Rosenblum says paying for that puts dental insurance out of reach. He hopes the new health exchange will make paying for health insurance easier. But even if he qualifies for health subsidies, dental care is not part of Vermont's exchange or the federal Affordable Care Act, also known as Obamacare.
"At one point we sold off some land six years ago, and we probably spent $7,500 on getting our teeth fixed up, and so it's really a difficult problem," Rosenblum said.
"So, you have private insurance which is expensive and limited," said Sen. Bernie Sanders, I-Vermont.
Sanders is sponsoring a bill to expand dental coverage to underserved patients. It would let people use federal health care subsidies through the Affordable Care Act to pay for dental plans. It also requires Medicaid to cover dental; it is optional for states now. It would have the VA provide dental services for vets even if the problem is unrelated to their service. It also would start training programs for dental therapists to offer basic dental services where there are few dentists.
"We have a very excellent team right now to provide that exact care," said Robert Faiella, the president of the American Dental Association.
The ADA supports expanding coverage to more patients, but does not support the idea of training dental therapists.
"It's not so much that we need more providers to treat dental disease, we need more education prevention efforts to stop the rate of the disease from increasing and then use our current system to make up for the shortfall," Faiella said.