Sunday, January 30, 2005

Medicaid Dental programs enticing to states with budget problems

COLUMBUS, Ohio - Disabled and unable to work, David Kuehl put off dental care for six years. After becoming eligible for Medicaid, he had several damaged teeth removed to ward off the infections he's prone to as a hemophiliac.

Medicaid coverage for adult dental services, which survived budget cutting two years ago, is back in the mix as Gov. Bob Taft and lawmakers say they need to look for savings everywhere in a spending plan already facing a $5 billion deficit.

Across the country, programs considered optional under Medicaid rules are enticing as states wrestle with stagnant revenue and soaring health care costs. The National Governors Association calls Medicaid reform its top priority this year.

"What's a word bigger than catastrophe?" said Barb Edwards, deputy director of Ohio's Medicaid program.

Kuehl, of Buckland in western Ohio, said he couldn't have afforded the $20,000-plus in treatment - which included a hospital stay - without Medicaid, which covered everything. And as a hemophiliac, he is subject to uncontrolled bleeding from even minor injuries or infections.

"Not only is it a financial burden, but it would also put my life at risk," the 48-year-old former maintenance worker said.

In the past three years, several states reduced adult dental coverage under Medicaid for budget reasons, including Michigan, Minnesota and Utah. In California, Connecticut, New Jersey and other states, intense lobbying by dentists blocked similar moves.

The number of states with comprehensive dental benefits for adults under Medicaid dropped to seven in 2004, down from 14 in 2000, according to an analysis by the American Dental Association.

In 2003, Minnesota added a $500 cap to dental services that don't include major procedures like extractions, saving about $1 million a year, said Brian Osberg, the state's assistant commissioner of health care.

As a result, some patients are choosing to have all their teeth pulled and replaced by dentures - which Medicaid still covers - rather than the less invasive procedures which they can't afford, said Richard Diercks, executive director of the Minnesota Dental Association.

The change was necessary because of state budget problems, and the cap was better than no dental coverage at all, said Republican state Rep. Tim Wilkin.

The reaminder of the article can be found here.

California's 2005 proposed budget enacts a $1,000.00 per person per year benefit.

Is it appropriate that the states provide any adult dental benefits at all?

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