Iowa researchers find ending Medicaid dental benefit costly

And this does't count costs from other health effects. Eg., tooth & gun problems can cause heart problems, even brain infection.

http://www.eurekalert.org/pub_releases/2015-05/uoi-irf052715.php

Public Release: 27-May-2015
University of Iowa

A new study suggests that states may not save as much money as anticipated by eliminating adult dental coverage under Medicaid.

The study from University of Iowa researchers looked at California, which decided to end adult dental coverage under Medicaid in mid-2009. Some 3.5 million low-income adults in the Golden State lost dental benefits.

The researchers found those adults made more than 1,800 additional visits annually to hospital emergency departments for dental care after losing the benefit. In all, California spent $2.9 million each year in Medicaid costs for dental care in emergency departments, up from $1.6 million before the state eliminated the adult dental care benefit. That's a 68 percent increase in costs, when factoring inflation.

Since 2010, five states -- Arizona, Massachusetts, Pennsylvania, South Carolina, and South Dakota -- have either curtailed or eliminated adult dental benefits under Medicaid. Other states, notably Illinois and Missouri, are considering some limits to coverage.

"I think the important point here is although the Medicaid dental benefit for adults is optional, savings derived from dropping the benefit are somewhat eaten up by the increased costs from adults seeking dental care in hospital emergency departments," said Astha Singhal, a postdoctoral researcher in the UI College of Dentistry and corresponding author on the paper, published this month in the journal Health Affairs.

Fifteen states, including Iowa, currently offer comprehensive dental benefits for low-income adults.

The states' deliberations come as the federal government, under the Affordable Care Act, will pick up upwards of 90 percent of the Medicaid bill to states that offer dental benefits to adults through 2020. After that, the costs will shift gradually to states.

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Other states have shown similar increases, according to other analyses.

Oregon saw a doubling of emergency department visits for unmet adult dental needs after eliminating the Medicaid benefit in 2003. It has since restored the benefit. Meanwhile, Maryland experienced a 12 percent increase in the rate of emergency department visits by adults for dental care after dropping the Medicaid benefit in 1993.

"Providing dental coverage facilitates access to dental care, whereas when cutting dental benefits, patients have no option but to go to hospital emergency departments, which are not equipped to treat them appropriately," said Singhal, who has a research appointment in the UI's Public Policy Center.