Keep Kentuckians Smiling: Protect Dental Benefits in the Proposed 1115 Medicaid Waiver

woman_brushing_teethWhen the Bevin Administration released the Section 1115 Medicaid Waiver, Kentucky HEALTH, this summer, we voiced our concern about classifying dental benefits as an earned benefit instead of included in the standard benefits package (as it is currently). The Administration held three public comment periods this summer, and made several adjustments to the waiver, including one that impacts dental coverage, before submitting it to the Center for Medicare and Medicaid Services (CMS) for approval. The adjustment allows for a three-month delay to provide time for individuals and families to accrue rewards dollars for their dental care through their new My Rewards Account. While we are grateful that the Administration made this modification to the waiver, it still doesn’t address the major issue of dental benefits considered as an earned benefit.

“It would be very difficult for a patient who is already in pain from infected, mobile, and aching teeth to earn any benefits,” says Jefferson County Registered Dental Hygienist, Jennifer Hasch. “Pain and infection prevent people from learning, concentrating, working, and overall social participation. Oral care and wellness allow people to contribute to society, not the other way around,” says Hasch.

We need to make continued strides in advocating for the inclusion of dental benefits, not as an earned benefit, but rather as a key component in the standard benefits package. Receiving proper dental care allows for proper chronic disease management, a major aspect of the waiver. For example, diabetic patients with an infection in their mouth can’t stabilize blood glucose levels. The expansion of Medicaid coverage in 2014 provided patients who have had decades of limited access to care the ability to finally seek treatment.

The Northern Kentucky Health Department, which provides dental services to students through a school-based portable prevention program, doubled the number of students after Medicaid was expanded. Linda Poynter of Northern Kentucky Health Department points out that, “by utilizing the strong educational component of our program, we are able to educate parents on the need for dental prevention and treatment for themselves, not just their kids.” This was made possible by expansion, which provided families the ability to “both get out of dental pain and have a dental home of their own,” says Poynter.

By changing dental benefits to earned benefits, we detract from the positive strides we’ve made impacting both children and adults in Kentucky. Lawrence County’s Public Health Director, Debbie Miller, notes that it’s “essential we have the parents on board with [dental programs found in schools] and the [proposed 1115 Medicaid] waiver may limit that.” By teaching children proper oral hygiene, that is then practiced at home, children will take the practice into adulthood thus reducing or eliminating the current disparities.

According to Dr. William T Betz, acting Dean of Pikeville’s Medical School, oral health is already one of the most neglected parts of total health care. “There is a direct relationship to poor oral health, poor health, and financial affordability. Dental care is as important as diabetes, heart disease, and cancer – and they’re interrelated.” says Dr. Betz.

CMS has extended their public comment period on the Bevin Administration’s proposed 1115 Medicaid Waiver and they need to hear from you!

Check out Kentucky Youth Advocates action alert for instructions on submitting comments and talking points that include dental benefits in the standard benefits package instead of being classified as an earned benefit.