Press Releases

Last week, Reps. Jack Bergman, Jeff Van Drew, Don Davis, and Jared Golden introduced the SMILE for Veterans Act, bipartisan legislation establishing a Department of Veterans Affairs pilot program to reimburse community-based dental providers for care provided to rural Veterans.

Under current law, only about 15 percent of the nearly nine million Veterans enrolled in VA health care are eligible for VA dental services. Eligibility is generally limited to Veterans with a service-connected dental condition, a 100 percent disability rating, or former prisoner-of-war status.

“For too many Veterans in rural communities, basic dental care is either too far away or simply out of reach,” said Rep. Jack Bergman. “The SMILE for Veterans Act offers a practical solution by connecting Veterans with trusted dental providers already serving their communities. Rather than building an expensive new federal system from the ground up, this legislation uses existing local providers to deliver care efficiently and closer to home.”

Efforts to broadly expand dental coverage through the VA have faced significant cost and capacity challenges, including the need for additional personnel, facilities, and community-care infrastructure.

The SMILE for Veterans Act takes a targeted approach by creating a reimbursement pathway for existing community-based dental providers to serve rural Veterans. By leveraging providers and infrastructure already in place, the legislation would expand access to dental care in underserved communities without requiring the VA to build a new system from the ground up.

“I spent 30 years as a dentist, and I can tell you that putting off dental care usually only makes things worse,” said Rep. Jeff  Van Drew. “For veterans living in rural communities, sometimes the hardest part is simply finding a dentist close enough to get the care they need. That should not be the case. The SMILE for Veterans Act is a practical way to connect veterans with that care closer to home. To me, that is common sense.”

“Quality dental care is a critical part of keeping our veterans healthy, and too often, veterans in rural communities face significant challenges getting the care they need. The bipartisan SMILE for Veterans Act would give community providers across eastern North Carolina a way to deliver that care closer to home. Our veterans kept their promise to our nation, and we must always keep ours to them,” said Rep. Don Davis.

“VA health care is an essential benefit for our nation’s veterans, but for too long a lack of dental coverage has been a massive gap in care. The mouth is part of the body, and our veterans shouldn’t have to jump through hoops to get basic dental care. I’m proud to work with Reps. Bergman, Davis and Van Drew on the SMILE Act, which takes a smart first step toward more comprehensive coverage by focusing on rural areas where barriers to care are the highest and community providers that can help close the gap,” said Rep. Jared Golden.

The SMILE for Veterans Act is supported by AMVETS, the National Rural Health Association, and the CareQuest Institute for Oral Health.

In 2024, the CareQuest Institute funded 10 projects across the country to identify the barriers Veterans face in getting oral health care. The Upper Peninsula Commission for Area Progress (UPCAP) was among the recipients, and with the help of the funding, was able to hold community forums across the region. The forums brought together Veterans, servicemembers, families and caregivers, dental providers, insurers and health plans, and policymakers to discuss Veteran oral health and what keeps Veterans from getting care. The project, led by Frank Lombard, UPCAP’s U.P. Veterans Program Manager, produced troubling findings about the dental health and unmet needs of Veterans in rural Michigan. One survey of 835 Veterans found:

Poor oral health: More than a third of Veterans surveyed rated their oral health as only fair or poor.

Veterans are pulling their own teeth: 32 Veterans reported extracting one of their own teeth during or after military service because they couldn't get in to see a dentist – 1 in 8 of those who answered the question. Among Veterans who rated their oral health as poor, the rate was more than 1 in 4.

Widespread tooth loss: More than 75 percent of respondents who answered reported losing two or more teeth to decay or gum disease. Nearly 40 percent have lost six or more.

Enrolled in VA care, but no dental benefit: 83 percent of respondents are enrolled in VA health care, yet 44 percent reported they are not eligible for VA dental care, with another 32 percent unsure whether they qualify. Fewer than 2% reported being service-connected for dental care.

No dental insurance: Nearly 37 percent of Veterans reported having no dental insurance. Among those rating their oral health as poor, more than half are uninsured.

Cost is the leading barrier: Affordability was the most frequently cited reason for not visiting the dentist more often. That includes 43 percent of Veterans in poor oral health.

Long gaps in care: Nearly a third of Veterans had not seen a dentist in more than a year. More than 20 percent had gone three or more years. Among Veterans in poor oral health, 58 percent had not had a dental visit in the past year.

“The CareQuest Institute for oral health generously provided funding for the Upper Peninsula Commission for Area Progress to conduct a rural Veteran oral health survey across our region. The results revealed systemic issues regarding problems with Veteran access to dental care. Although the majority of the 835 Veterans who completed the survey reported being enrolled in VA healthcare (696/83%), only 162 (19.4%) reported being eligible for dental services through the VA. Approximately 34% of Veterans reported their oral health as being fair (166) or poor (123). 307 Veterans reported having no dental insurance and 15 reported being unsure if they had any coverage. Lack of eligibility for dental care through the VA and the cost of care were some of the most frequent barriers highlighted in the survey results. Those who reported paying the most out-of-pocket for dental care were middle and lower income categories. The survey also revealed that many Veterans are struggling with serious and painful dental problems such as broken and cracked teeth, cavities, and abscesses. 32 veterans who completed the rural Veteran oral health survey even reported having to extract one of their own teeth during or after military service because they could not get into a dentist in time. No Veteran should ever have to pull one of their own teeth after the sacrifices they have made. This is a problem that must be solved,” said Frank Lombard.

“No Veteran should struggle to get the dental care they need because of where they live. For veterans in rural communities, limited options and long distances can make accessing oral health care especially difficult, and we all have a responsibility to help close those gaps,” said Melissa Burroughs, Senior Director of Public Policy at CareQuest Institute for Oral Health. “This legislation is an important step in addressing longstanding barriers to care for rural veterans, and it’s encouraging to see leaders from both parties working together on such a critical need.”

“The National Rural Health Association (NRHA) is grateful to see the introduction of the SMILE Act, led by Representative Bergman, Representative Davis, Representative Van Drew, and Representative Golden. This legislation would establish a pilot program to improve rural Veterans’ access to dental care, addressing a critical need in rural communities where Veterans often face significant barriers to accessing essential health services. With one in four Veterans living in a rural area, ensuring access to dental care is an important part of ensuring rural Veterans can receive the comprehensive care they deserve,” said Alan Morgan, CEO, National Rural Health Association.