Tag Archives: ada

What early numbers tell us about kids’ dental coverage under ACA


Image by Herald Post via flickr.

Children’s dental benefits are listed among the 10 essential health benefits under the Patient Protection and Affordable Care Act (ACA). Yet there is no federal requirement that people buy dental coverage for themselves or their children when obtaining health insurance on state marketplaces.

That lack of a mandate is having an impact, a new study from the American Dental Association concludes.

An average of just 15.9 percent of children obtained stand-alone dental coverage along with their medical plans across the 37 states included in the study. By the same measure, more adults – an average of 20 percent – obtained dental benefits along with their medical plans, according to the ADA’s analysis of data gleaned from the February 2014 marketplace enrollment report submitted by the U.S. Department of Health and Human Services. Continue reading

Conference explores use of dental therapists to expand access to care

In November’s Health Affairs, Conan Murat explored his experiences as a dental health aide therapist (DHAT), providing care to his fellow native Alaskans in remote villages on the Yukon-Kuskokwim Delta.

Recently, Murat was in Washington, D.C., to join a crowd of oral health advocates who say technically trained dental providers could help answer the need for care in many other poor and isolated communities across the United States.

“This whole movement thing seems like it’s really starting to get going,” noted Murat, looking out over the crowd at the Dental Therapist Conference Convening, hosted by Community Catalyst, a national nonprofit promoting grassroots efforts to change the health care system.

Organized dental groups have fought hard against the therapist model in recent years, saying no one but dentists should be allowed to drill cavities and extract teeth. Continue reading

Dental therapist tells of treating patients in remote Alaska

Conan Murat, one of Alaska’s first dental health aide therapists, provides a first-person perspective on providing oral health care to his fellow Native Alaskans on the isolated Yukon-Kuskokwim delta in this month’s issue of Health Affairs.

One of the perks of belonging to the Association of Health Care Journalists is free access to online versions of a number of useful journals. Health Affairs is one of those and the November issue is dedicated to the theme of “Redesigning the Health Care Workforce.”

In one piece, “How to Close the Physician Gap,” the authors suggest that registered nurses and pharmacists could help address the disparity between the demand for primary care services and the number of physicians available to provide the care. Another looks at meeting growing health care needs through the wider use of nurse practitioners and physician assistants.

But Murat’s piece weighs in on another health care workforce issue that touches the lives of millions of Americans: the shortage of dental providers. Continue reading

NPR explores the right to at-home care for disabled patients

When it comes to summarizing the NPR news investigation “Home or Nursing Home,” you really can’t do much better than its tagline: “America’s empty promise to give the elderly and disabled a choice.”

The package is anchored by Joseph Shapiro’s wonderfully written profile of the family of a young woman who lives at home, despite the need for 24-hour intensive care. She’s 20, and Illinois Medicaid will stop covering her care as soon as she hits 21. Why?

It’s expensive to care for Olivia at home: nurses cost about $220,000 a year. Still, that’s less than half the cost of what the state counts as the alternative — having her live in a hospital. The Welters figure they’ve saved the state millions of dollars by keeping her at home.

But when she turns 21, the state changes how it measures cost. For an adult, the state says the alternative is no longer a hospital — it’s a less expensive nursing home.

At 21, Olivia and thousands like her around the country enter an uncomfortable gray area rife with lawsuits, acts of government and supreme court decisions. In fact, families like hers have lately been suing states – and winning. Shapiro explains how.

In 1999, the U.S. Supreme Court ruled, in Olmstead v. L.C., that under the ADA, people with disabilities often have the right to live in the community rather than in institutions. Since then, other federal laws and policies have said that states have an obligation to provide more home-based care. The new health reform law is filled with incentives for the states to spend more.

But federal law is contradictory. An older federal law, the 1965 law that created Medicaid and Medicare, says states have an obligation to provide nursing home care. Home care programs are still optional.

Also not to be missed: Shapiro’s profile of a patient advocate that doubles as a seamless history of how the system reached this point. A timeline and interactive graphic round out the package.