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Free clinic provides opportunity for broader examination of access to care Date: 01/23/19

Joe Lawlor

By Mary Otto

In coverage of a free dental care day for low-income Mainers, Portland Press Herald reporter Joe Lawlor explored some of the challenges that have shaped oral health access in the state.

As he noted in his piece, new Democratic governor Janet Mills is preparing to oversee an expansion of the state’s Medicaid program. Yet, the measure, which is expected to bring health care benefits to more state residents, could fall short in addressing their longstanding dental needs, Lawlor explained in his story.  

In this Q&A, Lawlor discusses his reporting on the outlook for improved oral health care in Maine. And he shares thoughts on the value of teamwork in covering the state’s long journey toward Medicaid expansion. 

Q: You turned what might have been a routine story on a free clinic into a piece that delved into underlying reasons that such events are needed. As you explained, one major barrier to care in Maine is a lack of basic adult dental benefits in the state’s Medicaid program. Are there efforts underway to get such benefits added to MaineCare? From what you have heard in your reporting, is there a sense that the incoming governor, Janet Mills, might be receptive to such a move?

A: Janet Mills, who became Maine’s governor on Jan. 2, has not said whether she will advocate for a dental benefit in the Medicaid program. However, Mills is a strong supporter of Medicaid expansion and public health, and the early readings on what her priorities will be as governor points to an emphasis on health issues. I would expect Maine’s dental care advocates to propose at a minimum a preventive dental care benefit for adults with Medicaid, and we shall see where it goes from there.

Q: For your free clinic story, you spoke with students and faculty from the University of New England’s new dental school. Is UNE expected to make a difference in getting care to more Mainers?

A: It has a chance to. The program is only five years old, and had its first graduating class in 2018. Of the 63 graduates, 18 stayed in Maine. The question is whether a higher percentage of students will stay, and if they do, will they spend at least a few years in areas of Maine where the dentist shortage is most acute.

Q: After your free dental care story ran, the Press Herald published a strong editorial calling for measures including the addition of basic adult dental benefits to MaineCare, more progress on the dental workforce front and the closer integration of dental services into the health care system.

A dental hygienist also weighed in with a commentary piece, highlighting stalled efforts to move forward with midlevel dental providers, approved by the state in 2014 but still not working in Maine. 

Q: Have readers offered any thoughts on the coverage?  

A: The story did get a pretty good response, mostly from people who need dental care and wanted to find a way to get care. I think readers do perceive the lack of dental care accessibility as an issue in Maine.

Q: Are you planning on following up with more reporting on oral health?

A: It is on the list, especially in the New Year with the new administration taking over. There will be many health care issues to follow up on.

Q:  Your free clinic piece offered a fascinating sidelight on a demanding, ongoing story that has kept you very busy lately: Maine’s long and difficult Medicaid expansion battle. Do you have any advice for fellow reporters on how you stay on top of a big story that just keeps unfolding over weeks and months?

A: Because Medicaid has an impact on so many people – more than 250,000, which is a lot in a small state like Maine (population 1.3 million) – the Press Herald made the decision to closely follow the expansion issue, in the courts and when it was on the statewide ballot in 2017. Myself and a team of political reporters and editors have followed every twist and turn, and along the way told the stories of ‘real people’ who have been impacted by the lack of medical coverage. Most of the folks who would be eligible for Medicaid under expansion do not qualify for subsidies under the Affordable Care Act, so they are among the most likely people to be uninsured. There is no magic answer for a media outlet. The bottom line is it takes resources and a dedication to staying focused on the issue, which I realize is challenging for news organizations in 2018 and beyond. Thank you for your interest in this topic.