Penny Wise and Pound Foolish: States cut Medicaid dental coverage for poor and disabled adults

An article in The Huffington Post by Daniel Lippman - "States Drastically Cut Dental Care For Adults on Medicaid" (10/02/12) - describes how states are cutting Medicaid dental services to restrain Medicaid spending.

According to the article, states that have recently cut Medicaid coverage of dental care for adults include: Pennsylvania, Massachusetts, Illinois, California and Washington. States are limiting or eliminating dental care for adults because they can. Dental care for adults is an "optional" service under Medicaid and is therefore an easy target for cost-cutting when budgets are tight.

• Washington State has preserved coverage for developmentally disabled adults and people in long-term care, while eliminating care for other poor and disabled adults. 
• Massachusetts will cover fillings, dentures, and root canals for front teeth hoping to make it easier for people on Medicaid to get and retain jobs, but back teeth (out-of-sight, out-of-mind?) are not covered.
• Illinois used to cover front teeth, but no longer. They will still cover emergency procedures such as extractions. 
• According to an NPR report on the lack of Medicaid coverage for adults in California, "In interviews with dozens of dentists and safety-net clinics around California, providers say patients are forgoing routine cleanings and delaying care until the pain is unbearable." 
• Pennsylvania has reduced Medicaid dental care for adults to basic services - cleanings, fillings and extractions.

Michigan is not mentioned in the Huffington Post article. Although the state continues to cover dental services for adults, the number of dentists who will see people on Medicaid has been drastically reduced by low reimbursement rates. This makes the program a virtually rationed system available to those who are lucky enough to find appropriate care or can find other ways to pay for it. Whether this saves money for the state is doubtful. There is increased reliance on emergency room visits to obtain painkillers and antibiotics to treat dental problems and more hospitalizations resulting from poor care.

Here is more coverage of dental issues in The DD News Blog.

This is the Medicaid Data Base describing Michigan's Medicaid coverage of dental care.