Medicaid Changes May Impact Adult Oral Health Care
Earlier this year, the Centers for Medicare and Medicaid Services announced it would allow state Medicaid programs to add work or community volunteering requirements for nonelderly, nonpregnant adults who are eligible for Medicaid for a reason other than disability.
Earlier this year, the Centers for Medicare and Medicaid Services announced it would allow state Medicaid programs to add work or community volunteering requirements for nonelderly, nonpregnant adults who are eligible for Medicaid for a reason other than disability. At presstime, four states have received permission to implement a work requirement for Medicaid eligibility, eight have requests pending, and six others have taken steps toward seeking permission, such as an order from the governor directing the state to apply for permission.1
How the work requirements will impact dentistry is likely to vary widely by state. As shown on the map, the work requirement will not impact dental care in Arizona, Alabama or Tennessee because these states do not provide dental benefits to adult Medicaid recipients. However, in states such as Ohio or Wisconsin — which offer extensive dental benefits to adult Medicaid recipients — the impact could be noticeable if the work requirement reduces the number of individuals eligible for Medicaid.
Researchers have found that when welfare recipients complete a dental treatment program, their employment prospects improve.2In addition, a survey of participants in Michigan’s Medicaid program reveals that those who used their dental benefit said it improved their health, appearance and employability.3 Considering the value of a nice smile to anyone seeking a job, these findings are not surprising. However, it could present a Catch 22 for adults and dental practices in states seeking Medicaid work requirements. Individuals who don’t wish to take part in Medicaid-related work or volunteering programs may find it difficult to access oral health care due to a lack of eligibility — which, in turn, could mean they don’t receive dental treatment that could raise their chances of finding employment. From the dental practitioner’s perspective, the Medicaid work/volunteering requirements could also mean seeing fewer patients from this population.
According to the health care advocacy group Families USA, oral health care stakeholders should watch how their states propose to implement work requirements, and help legislators avoid unintended consequences from restricting access to dental care
- National Academy for State Health Policy. A Snapshot of State Proposals to Implement Medicaid Work Requirements Nationwide. Available at https://nashp.org/state-proposals-for-medicaid-work-and-community-engagementrequirements/. Accessed July 13, 2018.
- Hyde S, Satariano WA, Weintraub JA. Welfare dental intervention improves employment and quality of life. J Dent Res. 2006;85:79–84.
- Kieffer E, Goold S, Tipirneni R, et al. The impact of Michigan’s Medicaid Expansion on Dental Care Access, Utilization and Health. Available at: https://academyhealth.confex.com/academyhealth/2017arm/meetingapp.cgi/Paper/16388. Accessed July 13, 2018.
From Decisions in Dentistry. August 2018;4(8):46.