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Spokane, Washington  Est. May 19, 1883

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Dr. Elisabeth Warder: Cutting Medicaid adult dental would further devastate vulnerable communities

By Elisabeth Warder CHAS Health

Since the last recession, our state has come a long way to support essential oral health care for low-income and underserved communities. But now, more than 1 million Washingtonians are at risk of losing their Medicaid dental coverage, including many of the folks facing the worst health and economic consequences of the pandemic – communities of color, people with chronic health conditions, and older adults.

As legislators grapple with how to address a serious budget shortfall, cuts to many health care and social programs are on the table, including the Medicaid adult dental benefit. As the dental director at CHAS Health, I urge our elected officials to preserve the programs that provide essential health care to vulnerable communities hit hardest by the pandemic.

We know oral health is integral to overall health. Untreated oral disease leads to inflammation and can have serious consequences on chronic conditions such as diabetes. It is also linked to heart disease, stroke, pneumonia, and pregnancy complications. Heart disease and diabetes are major risk factors for COVID-19. We should not further endanger the communities most at-risk of COVID infection and death by cutting health care that can protect them from the virus.

If we neglect basic preventive oral health care and disease prevention, it affects the body’s systemic health. As an example, a patient in her late fifties came into one of our clinics after three years since seeing a dentist. During that time, she was diagnosed with Type II diabetes. Her blood sugar levels were dangerous, and her mouth was diseased with swollen and bleeding gum tissue. Diabetes is linked to poor oral health and vice versa. Due to sensitivity, we treated only half her mouth to give it time to heal. When she came back two days later, the areas that had been cleaned were healthy, and she commented on how much better she felt. Her blood sugar was down that morning too. Treating the mouth is the gateway to the body.

Adult Medicaid dental is helping change lives every day. This patient would have never been able to afford preventive dental care, but thanks to Medicaid coverage, she is feeling better and learning how to care for her oral and overall health. For people who have been laid off during the pandemic, dental care is particularly important as they look for employment. Lost teeth and other signs of poor oral health negatively impact people’s ability to find work. Good oral health is an essential component of Washington’s economic recovery.

We need to learn from our past and maintain health care support for at-risk communities. During the last recession the state cut Medicaid adult dental, and it had long-term devastating impacts on patients and the dental system. By the time it was restored in 2014, patients faced a long-term accumulation of severe problems, including long-term pain, broken teeth, tooth abscesses, unnecessary extractions, and gum disease. Those cuts did not save us money over the long term, as eliminating prevention and early treatment results in higher medical costs.

Cutting the adult Medicaid benefit not only will cause severe health outcomes, it will actually cost money. It simply does not make financial sense. Our state would lose out on a significant federal match that covers more than 70% of the total program costs. Any “savings” would be significantly offset by lost federal dollars and increased costs in care. Additionally, community health centers like CHAS that serve low income patients and patients without insurance would lose dental revenue that they rely on to provide affordable care.

It is unacceptable that anyone should have to suffer with oral disease because it’s painful, harmful, and preventable. Cutting Medicaid adult dental will hurt vulnerable communities at a significant cost to taxpayers in the long run. The state Legislature needs to recognize that access to dental care is essential for health equity and preserve the Medicaid adult dental program.

Dr. Elisabeth Warder is the dental director at CHAS Health, where she practices at the Denny Murphy Clinic.