A growing number of states are offering dental care to low-income adults who in the past had to rely on charity or the emergency room to treat their tooth aches. From Tennessee to Maine, lawmakers have agreed to spend hundreds of millions of dollars to offer adults on Medicaid, the federal health program, to get dental care. The federal government doesn’t require states to provide dental care to adults through Medicaid, only to children.
Several states have offered limited or no dental coverage to their poorest residents. That has changed since the pandemic, with lawmakers embracing the idea that expanded care saves money and has other health benefits and nearly two dozen states agreeing to expand care. Since 2020, nearly 30 states have spent tens of millions of dollars to offer or expand care, according to CareQuest Institute for Oral Health, a nonprofit that advocates for expanded dental care.
READ AP’S STORY
FIND YOUR STATE: STATES THAT RECENTLY EXPANDED DENTAL CARE
These states have begun or expanded dental care since 2020. We’ve highlighted six states that in 2023 began or expanded their Medicaid programs to provide at least some coverage for adults. The level of coverage can vary. For details, contact your state Medicaid offices. Use the state drop down on right on this Medicaid page to get state specific contact info.
Hawaii – Began or expanded care in 2023
Kentucky – Began or expanded care in 2023
Maryland – Began or expanded care in 2023
Michigan – Began or expanded care in 2023
New Hampshire – Began or expanded care in 2023
Tennessee – Began or expanded care in 2023
FIND YOUR STATE: SOME STATES WITH LIMITED CARE
Care in these states varies so contact your agency for details, but access is generally limited to certain individuals, like pregnant woman or people with intellectual or physical disabilities, or to certain kinds of services, such as emergency care only.
Alabama (Alabama used to offer no dental coverage, but recently expanded to include pregnant woman only).
WHY SOME STATE PROGRAMS ARE STRUGGLING TO REACH THE POOREST PATIENTS
Despite the expansion of care, many states are struggling to provide dental services to the poor. One reason is that it can be hard to find dentists who will take Medicaid patients, especially in rural areas, resulting in long waiting times and hours-long drives in search of care.
Part of that is due to Medicaid’s low reimbursement rates. You can view an analysis of Medicaid rates by the American Dental Association based on 2022 data here. Please note that this list does not include states with recently expanded care. On the lower end, New Jersey covers as little as 13% of the cost of a dental procedure for adults. Michigan is at 17%, Rhode Island is at 22.4% and Illinois, Oregon, New York and Ohio are at a little over 28%. Most states, however, reimburse at rates for adults between 30% and 50% with North Dakota and Alaska offering at least 55%. Delaware was the highest at 76.9%. Coverage rates are typically higher for children. Medicaid rates, experts say, are driven by the cost of care and the amount of money a state puts into their program.
To find out the percentage of dentists in your state that accept Medicaid and the latest reimbursement rates, contact your state Medicaid agency.
CONSIDER THESE REPORTING THREADS
— In states where expansion has happened, ask how the rollout is going. Talk to advocates promoting expanded dental care, dentists, lawmakers supporting the issue, Medicaid patients and the state to learn about the benefits of the new or expanded program. This is a good opportunity spend some time with a patient who is seeing a dentist for the first time and explore the differences that treatment is having.
— This is also a chance to learn about any issues that are hampering a program’s success. Often, the headlines will focus on the positive aspects of the rollout without exploring the challenges. Dentists and their patients are great sources to understand the hurdles facing the program, including billing and access.
— In states where expansion is not happening, explore what it has meant to go without a dentist. Advocates, lawmakers and dentists can share data on the link between health problems and lack of dental care as well as how that impacts a patient’s employment prospects. The Medicaid recipients can share stories about their struggle to get care and the pain they have gone through enduring rotting teeth. Lawmakers in these states can talk of their years-long effort to expand care and the struggles they have faced getting support in the legislature.
VIEW THESE ADDITIONAL RESOURCES
NOTE: Coverage plans can change quickly. These resources can offer a place to start, but contact your state Medicaid agency for current information on the status of dental coverage.
The American Dental Association (Note, the ADAs information is not up to date in terms of states that offer care)
CareQuest Institute For Oral Health — a nonprofit that advocates for expanded dental care
Sep 25, 2023 8:33 AM – 969 words
Eds: UPDATES: With AP Photos.
Cover Photo: Cindy Clemons, center, receives dental care from Meharry Medical College School of Dentistry third-year student Onyeka Oguagha, left, and oral surgery resident Matthew Moore, right, Tuesday, Sept. 12, 2023, in Nashville, Tenn. Clemons was able to receive treatment after an expansion of the state’s Medicaid program. (AP Photo/George Walker IV)