On Capitol Hill, lawmakers are doing everything in their power to pass some kind of legislature regarding public health. Even without taking a side in the debate, there is a clear mood of desperation that many feel could create a “bad-to-worse” situation. This is true of people in the private sector, but also of professionals. Dentists around the country are aware that the dental coverage children receive — and the coverage some adults get through their state’s Medicaid plans — could soon disappear. 

The concern is well-founded: one of the tenets of the Affordable Care Act (Obamacare) is that any plan offered must meet 10 basic requirements … one of which is the availability of pediatric dental care. This is not just for private plans: Medicaid plans are held to these same requirements. That means states must provide dental benefits to children covered by Medicaid. This is no small thing. In parts of our country, upwards of 80 percent of children under the age of 6 are enrolled in Medicaid. But at least one of the bills up for consideration wants to eliminate this requirement and let the individual states decide which benefits policies must contain.

This is bound to cause confusion at best, and deny coverage at worst. The threat comes from the movement to make Medicaid a block grant. Currently, Medicaid is an entitlement, which means if you qualify, you’re guaranteed coverage. It’s paid for by a combination of state and federal dollars. Making it a block grant, however, would mean states would receive yearly a lump sum from the federal government; they would use that money (plus anything else they wanted to contribute) to create and manage the program as they saw fit. While might not seem like a bad idea on paper, it would almost surely result in less overall funding and more challenges in getting care for low-income people.

If the block grand idea gets pushed through, reimbursements to dentists would probably drop accordingly. Based on what has happened in healthcare so, it’s safe to assume that lower payout rates would lead to a shorter list of providers. An overall smaller budget combined with no requirement to cover dental would, experts feel, lead to a drop in low-income pediatric patients receiving dental care … or even seeking it at all. In truth, adults don’t fare much better: already, the few states that opt to offer dental coverage typically restrict that coverage to basic necessities like extractions and emergency services.

While the benefits vary by state, adult dental coverage through Medicare is almost always capped in terms yearly allowances.When budgets get tight, adult dental has always been one of the first benefits to be cut (although in all fairness, said coverages may be restored, depending on the budget). But the importance of maintaining coverage for children cannot be stressed strongly enough. A recent report by the ADA concluded that “Dental insurance played a significant role in children’s use of dental services and their level of unmet dental needs.“

Removing that benefit from Medicaid seems to be a huge step backward. Healthy teeth are a critical component of overall health: even in America, poor oral health has been linked to everything from heart and lung disease to stroke and diabetes. When dental coverage declines, studies show overall health declines, as well. This is tragic even in adults, but at the very least, we cannot lay this burden on children … not when we have proven programs in place that point to the success of early intervention.