Tim Kaine: Having A Child Has A ‘Triple Whammy Effect’ On Medical Cost And Debt

2 months ago

Earlier this month, Sen. Tim Kaine (D-VA) questioned experts on medical costs and debts related to parents during a Senate Health Education Labor and Pensions Committee hearing.

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Transcript

00:00Senator McCain. Thank you, Chair Sanders and Ranking Member Cassidy, and thanks for this

00:06wonderful testimony, extremely illuminating. I want to dig into two issues, medical debt and

00:11parents, and then medical debt related to dental costs. Ms. Ward, I'm going to start about medical

00:17debt with parents and ask you a question. High medical costs connected to pregnancy and child

00:22birth are significant financial burdens for new moms and new parents. About half of births in the

00:28country are covered by private insurance, and 2022 analysis of claims data suggests that

00:34out-of-pocket costs for moms about $3,000 in addition to other costs that they incur.

00:40A recent survey of people experiencing health care debt found that parents generally are

00:44significantly more likely than non-parents to have health care debt because of their own or

00:50their children's condition. And the debt that's being reported for moms does not include other

00:56medical debt that they may have incurred for the children. This is just around childbirth.

01:01Medical care for infants can result in higher out-of-pocket costs and debt. And then the

01:05out-of-pocket costs connected with pregnancy and childbirth, particularly for new parents,

01:11come at a time when families are experiencing income loss if you work with one of the 75%

01:16of the employers in the country that doesn't often offer paid parental leave. And also,

01:22if you're looking for child care in a nation that doesn't do a very good job of funding

01:25affordable child care, having a child puts this kind of triple whammy effect on you.

01:31The ordeal that you and your family face sounds very harrowing. And you mentioned

01:35in your testimony that you were forced to ration care due to the financial impact

01:39of these outstanding hospital bills. Talk a little bit about how debt relief

01:44would have impacted the lives of you and your family as your children were young.

01:49I think the main thing is that some of our care and some of our expenses were

01:54not just related to the hospital care. It came later for therapy and other kinds of treatment.

02:00So I think if we had had the opportunity to have debt relief, we would have pursued those

02:06therapies sooner, or we would have continued all the necessary treatment that was recommended for

02:10the children in a way that was consistent with what their treatment plan looked like.

02:15So if we could figure out a path forward on debt relief, this would be a very pro-parent,

02:20pro-family, pro-child policy. And I think that's an important thing. And I want to ask

02:26Dr. El-Saheed a little bit about dental bills. Senator Baldwin and I in March led a letter from

02:32a group of colleagues to the administration about persistent coverage gaps in essential health

02:37benefits. We asked the administration to initiate rulemaking to institute a minimum standard of

02:43coverage and to establish a permanent structure to regularly review what essential health benefits

02:49Not long after receiving our letter, the administration issued a final rule

02:53expanding access to dental benefits by finalizing measures to allow states

02:57the option to add routine adult dental services as an essential health benefit. So for the first

03:03time, every state will be able to update their EHB benchmark plans to include routine non-pediatric

03:09dental services, cleanings, diagnostic x-rays, restorative services like fillings and root

03:14canals. I hear from Virginians about this all the time. Problems with lack of dental care,

03:23distance from dental service provision leading to huge health and other challenges. In your

03:29testimony, you mentioned that dental bills are one of the leading causes of medical debt with

03:33almost half of adults reporting them as the cause of their medical debt. We've taken a small but

03:39important step in updating the EHB to allow for dental coverage. Can you speak to the

03:44impact that that debt related to dental bills has on your patients? Yeah, Senator, thank you for your

03:51leadership. I'll tell you, you know, we do this weird thing in this country where we decapitate

03:56the head from the body. So if it's health care for your teeth or your ears or your eyes or even your

04:01mental health, we consider it something different and apart. But we all know what happens if you

04:05decapitate a body. And thank you for your leadership on this front because I do hope that states will

04:11take up the mantle of including this as an essential health benefit. We often think about

04:16teeth as being something separate and apart because it feels like what happens in the mouth stays in

04:20the mouth, except for we all know also that the mouth is the gateway to the rest of the body. And

04:25we know that patients with significant dental caries or other oral pathology are far more

04:30likely to suffer long-term chronic health illness. You know, you think about something like heart

04:35disease related. You think about something like lung disease also related. And if I can interrupt,

04:42sometimes a dental examination also reveals non-dental health conditions that are really

04:48important to catch early. You're correct. You think about oral cancer often diagnosed at a

04:54dentist. So, you know, part of the responsibility here of thinking about debt is thinking about debt

04:59collectively rather than making the mistake of, again, decapitating the head from the body.

05:04As we think about medical debt, given the statistic that you shared, nearly half of medical

05:09debt attributable to dental care. We need to be thinking about it collectively. Thank you so much.

05:15Thanks, Mr. Chair.

Tim Kaine: Having A Child Has A ‘Triple Whammy Effect’ On Medical Cost And Debt

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