Giving teeth to Medicaid

The promise of enhanced access and preventive care was the force that through Congress drove the Affordable Care Act. Now the healthcare mosaic falls together, and that includes oral health. The Washington Legislature must act to provide dental coverage to Medicaid-insured adults as a requisite feature of Medicaid expansion.

“Expansion” is something of a misnomer. Last year, the U.S. Supreme Court, in upholding the Affordable Care Act, ruled that states may determine separately whether to participate in expansion. The move, which saves the state $225 million in the 2013-15 biennium, will allow 250,000 more Washington residents to receive health care.

While services extend to the previously uninsured, including those currently eligible but not enrolled in Medicaid, the federal government is picking up the tab until 2020. In practice, state expenses would be higher if Washington opted out, and few states are giving that serious consideration.

Here’s the catch: Medicaid-insured adults lost their dental coverage in 2011, with exceptions made for pregnant women and some seniors. In 2013, lawmakers in Olympia can restore coverage for adults in the state’s Medicaid plan by applying a portion of the expansion’s savings — approximately $15 million a year.

As the Washington Dental Service Foundation notes, dental coverage under Medicaid is a smart, cost-savings strategy. The top reason for the uninsured to race to the emergency room is for a dental complaint. That’s 54,000 dental-related visits to Washington emergency rooms, a drain of $36 million over 18 months. The ER docs can’t treat the underlying condition, the gum disease, for example, that drives a tooth abscess. This is similarly true for community health centers slammed with dental emergencies. Uninsured patients who could have had a filling are getting their teeth yanked.

Providers such as Dr. Marcia Wharton, medical director at Providence Everett Healthcare Clinic, witness it daily. The costs, human and financial, are enormous.

Teeth are windows to the resume. Recruiters for customer service jobs (or most jobs, for that matter) tend to look askance at applicants with teeth resembling the North Cascades. The health consequences are more severe. Untreated gum disease aggravates diabetes, which can then lead to heart problems, renal failure and amputations (!) Gum disease is already linked to heart attacks, stroke and pneumonia.

Extending oral-health coverage to 780,000 Washington residents is a proactive policy. Lawmakers agree, at least in the abstract. Dental coverage should be integrated into the fabric of Medicaid coverage. Oral health and overall health are one.

Talk to us

> Give us your news tips.

> Send us a letter to the editor.

> More Herald contact information.

More in Opinion

toon
Editorial cartoons for Sunday, April 27

A sketchy look at the news of the day.… Continue reading

County Council members Jared Mead, left, and Nate Nehring speak to students on Thursday, Jan. 30, 2025, during Civic Education Day at the Snohomish County Campus in Everett, Washington. (Will Geschke / The Herald)
Editorial: Students get a life lesson in building bridges

Two county officials’ civics campaign is showing the possibilities of discourse and government.

(NYT1) VATICAN CITY, April 19, 2005 -- VATICAN-CONCLAVE-1 -- Sisters with the order Lamb of God look in the direction of the chimney over the Sistine Chapel waiting for the telltale smoke to indicate the Cardinals voting on a new pope, Tuesday, April 19, 2005 in St. Peter's Square in Vatican City. (James Hill/The New York Times) *MAGS OUT/NO SALES*
Comment: How the conclave of cardinals will chose next pope

Locked in the Sistine Chapel, 252 members of the College of Cardinals will select a new pontiff.

Offer religious study outside of the school day

Everett school district taxpayers spend millions of dollars every year funding school… Continue reading

Greene has background, skills for Everett mayor’s office

I am endorsing Dr. Janice Greene for Mayor for the City of… Continue reading

Thanks for a fun, positive story about a young author

A recent front-page story was very encouraging and uplifting to read (“Edmonds… Continue reading

Let Trump tax cuts expire to trim deficits

The 2017 tax cuts that President Trump pushed through Congress are set… Continue reading

Roberts: Gutting of scientific research will leave us blind

The Trump administration’s deep cuts to science and research will harm our economy and environment.

Comment: Funding delays jeopardize research of healthy aging

A freeze of NIH funding threatens research into aging and Alzheimer’s at the UW School of Medicine.

Comment: Meaningful law on rent requires bill’s earlier version

As lawmakers seek a deal, rent stabilization should keep a 7 percent cap and apply to single homes.

Forum: Trump cuts to museum funding hit Imagine Children’s

The defunding of a museum and library program means the loss of a science lab for preschoolers.

Forum: We strive for Belonging, then keep it to ourselves

From childhood we treat Belonging as something to be jealously guarded. What if others belong, too?

Support local journalism

If you value local news, make a gift now to support the trusted journalism you get in The Daily Herald. Donations processed in this system are not tax deductible.