Assemblyman David DePietro, R-East Aurora, is pictured on a recent lobbying trip to Washington, D.C. DePietro is proposing a $5 million state-backed dental insurance program for veterans because too few veterans qualify for Veterans Administration dental benefits.

A state lawmaker wants to create a $5 million state-backed dental insurance program for veterans.

According to the Institute for Oral Health, 80% of veterans eligible for care through the VA aren’t eligible for dental coverage or care because dental benefits are extended only to veterans who have been a former prisoner of war, are 100% disabled or have a service-related dental injury. Institute officials say that often means, compared to non-veterans, veterans have consistently higher rates of gum disease, missing teeth, and filled teeth. Veterans are also more likely to have chronic conditions such as diabetes and heart disease that are associated with poor oral health and often lead to higher out-of-pocket costs for patients.

Assemblyman David DiPietro, R-East Aurora, recently introduced A.9258 in the state Assembly to create a statewide veterans’ dental insurance coverage program. The program would come with a $5 million budget appropriation to the state Department of Civil Service.

“Dental care is an essential component of overall health, yet many veterans face significant barriers to accessing affordable dental services,” DePietro wrote in his legislative justification. “Federal Veterans Affairs (VA) dental benefits are limited and often restricted to veterans with certain service-connected disabilities or specific circumstances.

As a result, thousands of New York veterans – particularly those with partial disabilities or low incomes – lack adequate dental coverage.”

Advocates have pushed for change for at least a decade, including participation in the VETSmile program, efforts to increase resources for VA Dentistry, supporting the VET CAR Act H.R. 2410 in the House of Representatives). The U.S. House of Representatives on Dec. 16, 2024, approved an ADA-supported bill that addresses home care and caregiver programs provided by the U.S. Department of Veterans Affairs. The Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act passed in a 382-12 vote. The bill would create a pilot program for veterans currently ineligible for VA dental benefits to receive VA dental care if they have been diagnosed with ischemic heart disease. The ADA also expressed support for provisions requiring a report that would review, among other things, the impact of current reimbursement rates to dental care providers participating in the Veterans Community Care Program on the availability of dental care for veterans; establishing a pilot program that would hire dentists at VA medical facilities and dental specialists at Veterans Integrated Service Networks to review and approve dental treatment plans; requiring a report that would identify the resources needed to provide dental care to veterans currently eligible for VA dental benefits; and requiring reporting on the implementation and expansion of the VETSmile pilot program, which provides free or reduced-cost dental care to veterans who are ineligible for VA dental benefits. The bill was signed into law Jan. 2, 2025.

Those improvements don’t move quickly enough for DePietro. The East Aurora Republican proposes placing his veterans dental benefits program within the state employee dental insurance plan, providing comprehensive and routine dental care services to veterans living in New York state. Eligibility wouldn’t be extended to any person who applies while receiving equivalent or better coverage from another public or private third party insurer or insurance plan. The state Civil Service commissioner will establish a sliding scale for copayments based on a veteran’s income and disability level. Veterans with a disability rating between 10% and 50% would pay copays based on income while those disabled at a rating of 50% or higher would not have to pay copays.

“This legislation fills that gap by establishing a state-administered dental insurance coverage program specifically for veterans,” DePietro wrote. “By utilizing the existing state employee dental insurance plan infrastructure, the program ensures administrative efficiency while providing high-quality, affordable care. The sliding-scale copayment model ensures equity and access, reducing financial strain for veterans with limited income or higher disability ratings. This initiative honors New York’s commitment to its veterans by addressing an often overlooked aspect of their healthcare needs and improving their overall quality of life.”