New tip sheet can assist your coverage of threats to Medicaid dental benefits

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health and the author of "Teeth: The Story of Beauty, Inequality, and the Struggle for Oral Health in America." She can be reached at mary@healthjournalism.org.

Photo by U.S. Pacific Fleet via Flickr

Roughly 38 million low-income adults across the United States rely upon Medicaid for a broad range of health care benefits. But not all of them can count on obtaining even the most basic dental services.

While children are entitled to dental care under Medicaid, dental benefits for adults are only considered an option. Under federal law, each state determines the scope of its adult dental coverage.

Some states offer extensive dental benefits to adults covered by Medicaid. A few others offer no dental coverage at all or have attempted severe reductions. Kentucky Gov. Matt Bevin was criticized last month after dropping dental and vision benefits for an estimated 460,000 adult Medicaid beneficiaries who had been added to the state’s program under an expansion ordered by his predecessor.

Currently, 14 states — Arizona, Florida, Georgia, Hawaii, Idaho, Maine, Maryland, Mississippi, Nevada, New Hampshire, Oklahoma, Texas, Utah and West Virginia — limit adult Medicaid dental benefits to emergency-only care. Those programs typically only pay for extractions to relieve pain or acute oral infection but not fillings, root canals and other procedures that could help save the teeth and address underlying problems.

In a new issue brief, the nonprofit health advocacy organization Families USA offers an assessment of the limits of emergency-only dental coverage. The brief provides insights from dental directors and oral health coalitions regarding unmet needs and efforts to expand coverage in their states.

“Ultimately, this survey reinforces the fact that emergency-only dental coverage is better than nothing, but that states should invest in comprehensive Medicaid dental coverage for adults if they want to effectively keep their populations healthier and reduce costs,” the authors conclude.

Reporters: What is the status of adult Medicaid dental benefits in your state? Is coverage limited to emergency-only? For resources, check out this new AHCJ tip sheet.

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