In rural Michigan, 32 Veterans told researchers they had pulled out their own teeth because they could not reach a dentist in time. The finding is now central to a bipartisan effort to widen dental access without asking the Department of Veterans Affairs to build a new national system.
H.R. 10419 would test a three-year VA reimbursement pilot for community dentists serving rural Veterans.
The gap is large. Nearly nine million Veterans are enrolled in VA health care, but only about 15 percent qualify for VA dental services under current law. VA health care enrollment does not provide dental coverage by itself. Eligibility generally applies to Veterans with a service-connected dental condition, a 100 percent disability rating or former prisoner-of-war status, according to VA dental eligibility guidance.
The Michigan survey gives the proposal its clearest evidence. CareQuest-funded work led by the Upper Peninsula Commission for Area Progress surveyed 835 Veterans. More than a third rated their oral health fair or poor. More than 75 percent of respondents who answered said they had lost at least two teeth to decay or gum disease. Nearly 40 percent had lost six or more.
The proposal specifies $5 million for fiscal year 2027 and $20 million annually from fiscal years 2028 through 2030. The pilot would be organized within one year of enactment and operate in at least 10 rural locations across five states.
The coverage figures show where access breaks down. Although 83 percent of respondents were enrolled in VA health care, 44 percent said they were not eligible for VA dental care. Another 32 percent were unsure whether they qualified. Fewer than 2 percent said they had service-connected dental care.
Nearly 37 percent had no dental insurance. Cost was the reason cited most often for skipping visits. The published figures also show that 162 of the 835 participants, or 19.4 percent, reported eligibility for VA dental services. A total of 307 had no dental insurance.
The consequences are real.
Nearly one-third of the surveyed Veterans had not seen a dentist in more than a year. More than 20 percent had gone at least three years. Among those who reported poor oral health, 58 percent had not visited a dentist during the previous year. Frank Lombard of UPCAP said the survey also found broken and cracked teeth, cavities and abscesses. Some Veterans had pulled their own teeth.
Van Drew spent 30 years as a dentist. He said delayed treatment usually makes dental problems worse. Davis said the bill could give community providers across eastern North Carolina a way to treat Veterans closer to home. The NRHA estimates that one in four Veterans lives in a rural area. Long distances and limited provider options can block access to essential services.
The bill takes a narrow route because wider VA dental expansion faces shortages in personnel, facilities and community-care capacity. Its reimbursement plan would use providers and infrastructure already in place. It would not create universal VA dental coverage. It would give communities facing the greatest geographic barriers a defined way to seek care.
Recent reporting on VA dental benefits says the number of Veterans who qualify for covered care has grown dramatically. Treatment may take place in a VA clinic or through a referral to a private-practice provider registered to receive reimbursement. The proposed rural pilot would add community capacity without replacing existing VA channels.
Local dental services can also determine whether a problem is caught early or becomes an emergency. A community prevention report showed how direct local work can bring oral health risks into view. For Veterans who cannot afford care or travel long distances, awareness alone changes little.
The SMILE for Veterans Act is not a finished benefit. It does not close the VA's wider dental-coverage gap. The proposal is bipartisan, focused on rural areas and built around existing clinical capacity. The survey shows why eligibility rules are not enough for Veterans left outside the system. They need a practical route to a dentist before pain and tooth loss become the only care they can get.
