|On Friday, the federal court blocked the implementation of the Medicaid 1115 waiver, known as Kentucky HEALTH. In response to the Medicaid ruling on Kentucky HEALTH, the Bevin administration announced that Medicaid expansion adults no longer be offered the ability to purchase dental and vision services through their My Rewards account effective July 1, 2018. The Kentucky Oral Health Coalition’s executive committee firmly believes the inclusion of dental coverage should be a key component in the standard benefits package for the adult Medicaid population because it is a cost-effective measure to cover essential care. Prior to July 1st, Medicaid Expansion eligible adults had limited preventive and restorative dental coverage, which included exams, cleanings, x-rays, and fillings. Given our historic issues with poor oral health in Kentucky, we have made strides towards improvement in oral health by increasing access and preventive services. We as a Commonwealth cannot afford to move backward.
Receiving routine dental care allows for chronic disease management and early detection of chronic diseases that display symptoms in the mouth. The health of mouth impacts the health of the whole body — it doesn’t make sense to separate healthcare. After Medicaid expansion in 2014, over 100,000 more Kentuckians, mostly adults, received dental services than in 2013. Children also benefit when their parents have access to routine dental care. If parents have access to dental services, they will be likely to take their children, even if those services are covered under Medicaid or KCHIP.
Research from other states such as Maryland shows us that when adult dental coverage is not offered in the standard benefits package, emergency room (ER) usage rates increased by 22 percent. Increased ER rates due to dental issues visits would only provide immediate relief and will not treat the underlying dental issue. Dental-related ER care is at least three times as expensive as a dental visit, and inclusion of the dental benefit is relatively inexpensive for many states in comparison to the expected increased utilization of the ER due to dental issues.
Responding to the court ruling by eliminating an essential benefit, such as dental coverage for Medicaid expansion adults, is likely to increase costly ER visits, and negatively impact health outcomes for families, the workforce, and overall well-being in the Commonwealth. KOHC stands ready to collaborate with Governor Bevin and his administration to find innovative ways that increase access and utilization to preventive services while also saving the Commonwealth money.
Kentucky Oral Health Coalition Executive Committee