Oral health Medicaid benefits for adults are often viewed as an elective health care option, despite growing evidence that good oral health is integral to overall good health. Allocation of state Medicaid dollars for dental services averages about 2% of the total Medicaid budget. Thus, cutting adult Medicaid dental benefits is largely a symbolic cost-reduction mechanism for states; which unfortunately, does adversely affect those most in need. The ADA Health Policy Institute (HPI) has prepared at-a-glance reports
on an array of oral health indicators for each state and D.C.
According to HPI, Medicaid-eligible individuals are the principal population group that is growing with increasing demand for dental care. In response to this growth, some dental practitioners make a deliberate choice to be a participating provider treating a significant number of Medicaid-eligible individuals annually. Others opt “to do their share” and accept a modest number of these individuals, such as the “Take Five” programs that have proven helpful in several states, such as Colorado.
Due to changing patient demographics and a decline in the number of privately insured or self-pay patients seeking regular dental care, a growing number of private dentists have found that accepting Medicaid patients is no longer a choice, but a necessity to maintain practice viability.
Medicaid provides a uniquely comprehensive mandatory benefit package for children that includes oral health screening, diagnosis, and treatment services. In the last decade, with federal and state leadership, Medicaid and the Children’s Health Insurance Program (CHIP
) have made important progress in addressing gaps in low-income children’s access to dental care, boosting children’s use of preventive and primary dental services. However, even with a robust benefit package, securing access to dental providers and services has remained a consistent challenge and access to oral health care for low-income adults lags far behind. For more information about Medicaid, see http://kff.org/medicaid/
- Adult Dental Medicaid Benefits (HPI Research Brief)
- What is Keeping State Oral Health Leaders Up at Night