What happens if the adult Medicaid dental benefit goes away?

HPI research brief discusses potential consequences of federal Medicaid cuts

The potential consequences of eliminating the adult Medicaid dental benefit are highlighted in a research brief the ADA Health Policy Institute released March 21. 

Several committees in the House of Representatives have proposed reduced federal spending for Medicaid, including the Federal Medical Assistance Percentage given to states that expanded Medicaid under the Affordable Care Act. But reducing federal aid to state Medicaid programs would cause states to face considerable budgetary challenges to keep Medicaid beneficiaries enrolled and provided with the same level of services, according to the brief. 

“The adult dental Medicaid benefit would be particularly vulnerable to reimbursement, service and eligibility cuts under these circumstances,” said the brief authors, Deesha Bhaumik, Ph.D.; Ian Hedges, M.S.; Matthew Zaborowski, M.P.H., C.P.H.; Marko Vujicic, Ph.D.

The brief also includes an analysis estimating the fiscal impact of eliminating adult Medicaid dental benefits in the 41 states and the District of Columbia that currently offer them at a limited or enhanced level. It includes the increased medical costs incurred for emergency department visits and conditions such as diabetes, heart disease and pregnancy. Additionally, the analysis reviews past policy changes in some states with statewide Medicaid dental benefits and examines the impact of these changes.

For each state, HPI used the number of Medicaid-enrolled adults utilizing dental care to calculate estimated costs, finding that the elimination of adult dental Medicaid benefits would “significantly limit access to cost-effective preventive and early intervention dental care, ultimately contributing to poor oral and overall health.”

ADA President Brett Kessler, D.D.S., said the elimination or reduction of dental benefits under Medicaid would impact more than 36 million adults who currently have limited or enhanced dental coverage. 

“This new research shows states how lack of affordable dental care will dramatically impact our community’s overall health and the future of more economic burdens in the states,” Dr. Kessler said. 

The researchers found that the total one-year increase in the U.S. health care costs due to removing adult Medicaid dental benefits is $1.9 billion. This figure accounts for the increased costs due to emergency department visits for dental conditions and unmet periodontal needs among pregnant beneficiaries and beneficiaries with diabetes and coronary artery disease. 

It estimated the five-year total cost in the U.S. as $9.6 billion, with California and New York incurring the highest total costs at $2 billion and $1.2 billion, respectively. 

The brief also mentions the impact of removing the adult Medicaid dental benefit would have on employability for Medicaid beneficiaries. HPI estimates that more than 2 million individuals across states with an enhanced or limited adult Medicaid dental benefit will face challenges in obtaining employment due to lack of confidence, teeth appearance or persistent dental pain. 

The brief concludes by stating that possible cuts to the Medicaid program could result in more dramatic impacts than legislators anticipate, adding that several states have learned that eliminating these benefits has long-term consequences when it comes to health issues, financial strain and worsening health disparities. States that previously scaled back enhanced adult Medicaid dental benefits later reinstated them after witnessing years of detrimental health effects and increased financial burdens. 

“This research confirms what we have known for years about the importance of the adult Medicaid dental benefit to the overall healthcare system. I encourage all members and oral health stakeholders to use this research brief to proactively defend adult Medicaid dental benefits to your state and federal lawmakers,” Dr. Kessler said.