Connecticut position as the leader in Children’s Dental Medicaid is in jeopardy.
Gov. Dannel Malloy’s April 2016 budget proposal calls for a 10 percent cut to Children’s Dental Medicaid reimbursement rates and reduces eligibility for HUSKY A Parents to 133 percent of the Federal Poverty Level (FPL). Our state made significant strides from the low access to dental care for Medicaid-enrolled families in 1999 to the present and we cannot let this success to be rolled back.
In 1999, only 29 percent of children continuously enrolled in HUSKY A received any dental visit of any kind and only 110 of over 2,600 dentists practicing in the state provided substantial levels of care to children enrolled in HUSKY. The system was broken.
Dental caries (tooth decay) is the most prevalent chronic disease of childhood. Children miss more school days due to dental pain, infection and treatment, than due to asthma. Dental disease affects their ability to learn, eat, socialize and affects their overall health.
When HUSKY A parents are cut from the program, they lose dental coverage. Even if they enroll in health coverage under Access Health CT, which is unlikely, they do not get dental insurance. This impacts their children as 36 percent of children are less likely to receive preventive dental care if their parents do not receive preventive dental care.
Community collaboratives were formed in some of our major cities to address the problem by successfully initiating mobile-based dental programs in the schools, introduced dental clinics into school based health centers, increased the number of dentists and chairs in multiple Federally Qualified Health Centers and some community/hospital clinics, it only highlighted the need for more efforts.
Greater Hartford Legal Aid initiated a class action suit, Carr v Wilson-Coker, to enforce the federal mandate that the state should provide access to dental care for Medicaid managed care recipients that equals the access of others. The suit settled in 2008, resulted in:
- Increased children’s dental reimbursement rates to match approximately the 70th percentile of the market fees for dental care in 2005;
- Improved administration process for providers;
- Expanded the number of dental providers enrolled in Medicaid from a little under 600 in 2006 to 2030 in 2012; and
- Improved utilization rates of children seeing a dental provider from 46% in 2006 to 72% in 2012.
Furthermore, 2012 utilization rates by race/ethnicity were 76 percent for Hispanics, 72 percent for Caucasian, and 71 percent for both Black and Asian population, making this a success program addressing health equity.
All of this work has resulted in our current successes in the Dental Medicaid program. Today, the percentage of children with a dental visit in Connecticut currently ranks highest in the country!
The Connecticut Oral Health Initiative is invested in the effort to promote oral health for our state’s underserved populations. If the state wants to sustain programs that work, they should not initiate any cuts to Dental HUSKY or eligibility of HUSKY A Parents.
Today HUSKY dental serves more people at a lower cost to the state each year as children and adults move from treatment to prevention. We’ve made progress with significant effort from the community and we urge every legislator to reject a budget that includes cuts to this great program.
Mary Moran Boudreau is the Executive Director of the Connecticut Oral Health Initiative.