Washington state has done an admirable job of ensuring that children have access to dental care, but extending it to adults remains a sore point.
Apple Health (Medicaid) and programs like Access to Baby and Child Dentistry (ABCD) see to it that children can get exams, cleanings, fillings and extractions. As a result, the incidence of oral disease among young children has dropped. Advocates would like to do the same for adults, but the hurdles are significant.
The state’s Medicaid reimbursement rate for adult dental care is one of the lowest in the nation, about 29 percent of what private insurers pay. In many instances, that’s not enough to cover a dental office’s costs, meaning they can take a loss for every Medicaid patient they see.
Less than one-quarter of adults with Medicaid coverage have access to dental care. Those without access delay their care until it becomes an emergency. From 2011-14, the Legislature largely dropped adult dental coverage to balance budgets. Coverage has been restored, and now dentists are seeing a surge in people who had to postpone needed care.
The Washington Dental Services Foundation wants the state to increase the Medicaid reimbursement for the adult Medicaid population, but it also knows the Legislature is consumed with funding basic education this session.
So the foundation, a nonprofit supported by insurance provider Delta Dental, is making a small request of $1.5 million to help fund a pilot project aimed at covering pregnant women and adult diabetics by increasing their reimbursement rates.
Pregnant women are targeted as the next step to the foundation’s efforts to allay unfounded fears (from patients and dentists) about pregnancy and dental care, and to encourage families to move up a child’s first visit to age 1 rather than age 3. Women can transmit oral diseases to their babies before and after delivery, so they shouldn’t avoid the dentist. Dental caries is the most common childhood disease and is totally preventable.
Diabetes is targeted because it makes people more prone to gum disease, which makes it more difficult to control blood sugar. It’s important that diabetics have regular dental care to forestall serious health consequences.
Spokane would be a natural choice as one of the pilot sites, because of its historic commitment to expanding dental access. Plus, the region has relatively large Medicaid population. The ABCD program, which matches dentists to young children, was begun in Spokane. Ninety-eight of the area’s 166 dentists are participants.
If this experiment were to succeed, the potential savings in health care costs would dwarf the initial expenditure, and the outcomes could be used to justify higher reimbursements for all adults under Medicaid.
The Legislature would be wise to give this a chance.
To respond to this editorial, visit www,spokesman.com and click on “Opinion.”
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