Dental benefit proposed for Medicaid recipients

Source: Joe Lawlor/ Portland Press Herald

A bill introduced in the Maine Legislature would give access to preventive, diagnostic and restorative care for more than 100,000 Mainers.

AUGUSTA — Tifani Pedro said Wednesday that if the Maine Legislature passes a bill to provide adult dental coverage for people with Medicaid, it would be life-changing for her health.

The Old Town resident went to the state capital complex to testify in favor of a bill that would add a comprehensive dental benefit – including preventive, diagnostic and restorative care – for more than 100,000 adult Mainers who have Medicaid, but don’t have access to preventive dental care. Maine would join 33 states that have such a benefit.

Maine children covered by Medicaid do currently receive dental care through the program. Adults with Medicaid currently do not receive dental services, and Medicaid will only pay for emergency dental care.

Pedro, 40, said she is disabled, has no dental coverage and has lost nine teeth from a number of health issues, including cavities and gingivitis.

“I currently have a lot of broken teeth that cause me pain. I also have loose teeth from so many being extracted,” she said. “That means that slowly, my teeth will all need to be pulled.”

Pedro said Maine should be known for more than “having bad dental access because there’s quite a few of us walking around with very few teeth.”

No cost estimate has yet been attached to the bill, sponsored by Rep. Drew Gattine, D-Westbrook. But in 2016, the American Dental Association projected that Maine taxpayers’ share of the cost of an adult dental benefit under Medicaid would be between $7 million and $19 million annually. The federal government would pay between 67 percent and 90 percent of the cost of each patient’s dental care.

Advocates have argued that while paying for prevention has costs, it also saves money in the health care system because good dental care can prevent other diseases. A 2017 study for the National Association of Dental Plans found that a preventive Medicaid benefit for adults reduces medical costs by 31 percent to 67 percent for patients with chronic conditions, such as diabetes, high blood pressure, high cholesterol and asthma.

“Dental care is a vital part of good health,” said Kathy Kilrain del Rio, policy analyst for Maine Equal Justice, a public policy advocacy group. “Because oral health affects our physical health, impacts our employability and plays a role in our self-esteem and well-being, we cannot afford to continue to deprive low-income Mainers of access to needed care.”

Dr. Wendy Aplaugh, a Stonington dentist, said “oral health is intimately linked to overall health while oral disease is linked to diabetes, obesity, dementia, heart disease and other health issues.” The bill is supported  by the Maine Dental Association.

Mainers who earn up to 138 percent of the federal poverty level – $34,638 for a family of four – are eligible for Medicaid and would be covered for dental care if Gattine’s bill passes.

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