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Friday, May 26, 2017

Oral Health Lands on Advocates’ Agendas Across the Nation

Melissa Burroughs

Oral Health Government Affairs Advocacy Manager

Even as health care has become a politically charged issue this year, we’ve seen oral health advocates work diligently and some states make progress to improve oral health benefits in their Medicaid programs. This week, with overwhelming bipartisan support, Maryland became the latest state to authorize a dental benefit for adults in its Medicaid program. 

On May 25, Governor Hogan signed legislation allowing the state to provide coverage of more than just emergency room services, though the scope of what will be covered was not defined. The act is a huge win for Maryland advocates, led by the Maryland Dental Action Coalition (MDAC), who have been making the case for an adult benefit for years. 

Salliann Alborn, chair of MDAC, summarized the need for legislation in a statement: 

“[U]ninsured adults have virtually no access to care and as a result, we see increased emergency room visits and related systemic illnesses that can often have life threatening consequences… [with this benefit, Maryland] will raise the bar to improve access to oral health care like many other states have already done for their citizens.”

The legislation is also a big win for the state’s rural community, and the bill’s champion Delegate Michael McKay (R) from the western part of the state, where there is an acute need for such coverage.

Unfortunately, Maryland’s act does not provide the funding for this benefit - the state will still need to include it in a budget for the benefit to become a reality - but it does commission a study on emergency room costs and oral disease that is likely to make the case for the funding being cost effective. It isn’t a full victory yet, but Maryland’s actions prove that states can take big steps to improving oral health coverage, even in a difficult political environment. 

Progress for oral health in Arizona

Arizona also made incremental progress in adult oral health this year, adding a benefit to their Medicaid program that gives adults coverage for dental care in emergency rooms up to $1,000. On May 12, Governor Ducey approved the state’s 2018 budget, which includes funding for this very limited benefit. While almost all other states, including Maryland, already have this benefit, it is an important step for Arizona and could foreshadow further improvements in the future.  

Improving access to oral health care is on advocates’ agenda across the nation

In the United States, 2 in 5 adults do not have oral health coverage, leaving millions of people who cannot afford to pay for care on their own. This lack of coverage and care contributes to increased oral disease, poorer overall health, and even effects overall well-being through things like anxiety, employability, and nutrition.

Across the country, advocates in many other states are working hard to get better oral health coverage to their adult citizens. In states like Kansas, Virginia, and North Carolina, renewed efforts for Medicaid expansion could provide an in-road to improving dental benefits. In many other states, advocates are raising both the need and the economic case for why these benefits are so important, laying the ground work for years to come. 

Dental benefits in danger in some states

However, there are a number of places where Medicaid dental benefits are threatened. For one, if the federal government decides to cut Medicaid funding, states will be under enormous pressure to cut rather than expand oral health benefits. Some states, like Kentucky, are looking to make dental benefits more difficult to access through Medicaid waiver programs.

Kentucky’s waiver request, which is awaiting federal approval, would subject enrollees to work requirements and premiums for all of their coverage and force them to earn their dental benefits by completing certain wellness activities. 

Other states like Connecticut are looking to cap or restrict oral health services through prior authorization in the coverage they provide as their state looks to balance a budget. In these cases, advocates are working hard to remind lawmakers that Medicaid dental benefits are a good investment, both for people and for state budgets.

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