More Than a Smile: Dental Affordability Problems and Potential Solutions

Consumer Healthcare Experience State Surveys from multiple states have revealed that people with insurance still go without critical services due to cost.¹ Most frequently reported is dental care, with respondents across insurance types foregoing dentures, root canals, extractions, and many other dental services. Looking to Medicaid as an example, this webinar will explore the impacts of going without dental care on the whole body and other high-cost medical conditions, and some causes behind it such as limited coverage for dental care and a lack of providers accepting certain insurance types. It will also capture policy solutions and strategies for state administrators and advocates for low- and middle-income communities to expand access to affordable care.

National studies have found that dental care presents the highest level of financial barriers, compared to other types of health care services regardless of insurance type,² and that financial reasons such as “could not afford the cost” and “insurance did not cover procedures” are top barriers cited for not obtaining needed dental care.³

Medicaid offers some examples of how this can occur. Adult dental coverage is optional under state Medicaid programs, and as of 2023, only eight states offer an extensive Medicaid adult dental benefit.⁴ States also have significant flexibility with dental coverage and there is no standard packageof high-quality dental benefits across states. In addition, there is a dearth of dentists that will accept Medicaid insurances. National studies have found that adults with Medicaid or marketplace coverage are more likely than those with other types of insurance to experience provider network problems.⁵

Poor oral health is connected to a higher risk for diabetes, cardiovascular disease and stroke, complications in pregnancy and childbirth, and other conditions that are costly to treat.⁶ These conditions impact quality of life and can ultimately result in more intensive and higher cost medical care over a person’s lifetime.

Date and Time

October 26, 2023
2:00 p.m. – 3:00 p.m. EST 

Speakers

• Kasey Wilson, Community Catalyst: Gaps in Dental Coverage, Consequences of Foregoing Care, and Policy Solutions
• Marcy Bowers, Statewide Poverty Action Network: Impact on Affected Communities
• Emily Brice, Northwest Health Law Advocates: Leveraging Stories and Engaging
  Policymakers
• Alexandra Allen, Altarum Healthcare Value Hub: Moderation and Q&A

Resources

• Medicaid Adult Dental Benefit Coverage Checker (CareQuest)
• Five Key Takeaways about Medicaid Adult Dental Benefits in 2023 (CareQuest)
• Preserving and Expanding Medicaid Adult Dental Benefits (CareQuest)
• Dental Access Project (Community Catalyst)
• Dental Therapists: Expanding Access to Oral Health Care (Community Catalyst)
• Washington Dental Access Campaign (Washington Dental Access Campaign)

Footnotes

1. ^{Consumer Healthcare Experience State Survey. Altarum Healthcare Value Hub. https://www.healthcarevaluehub.org/advocate-resources/consumer-healthcare-experience-state-survey}
2. ^{Vujicic, M., Buchmueller, T., & Klein, R. (2016). Dental Care Presents The Highest Level Of Financial Barriers,
   Compared To Other Types Of Health Care Services. Health Affairs, 35(12), 2176–2182.
   https://doi.org/10.1377/hlthaff.2016.0800}
3. ^{Gupta, N., & Vujicic, M. (2019, November). Research brief main barriers to getting needed dental care all relate
   …Main Barriers to Getting Needed Dental Care All Relate to Affordability. Main Barriers to Getting Needed
   Dental Care All Relate to Affordability. https://www.ada.org/-/media/project/ada-organization/ada/adaorg/
   files/resources/research/hpi/hpibrief_0419_1.pdf}
4. ^{Auger, S. (2023, July 10). Five key takeaways about Medicaid adult dental benefits in 2023. CareQuest Institute
   for Oral Health. https://www.carequest.org/about/blog-post/five-key-takeaways-about-medicaid-adult-dentalbenefits-
   2023}
5. ^{Hinton, E., & Raphael, J. (2023, June 15). Medicaid Managed Care Network Adequacy & Access: Current
   Standards and Proposed Changes. KFF. https://www.kff.org/medicaid/issue-brief/medicaid-managed-carenetwork-
   adequacy-access-current-standards-and-proposed-changes/}
6. ^{An Overview of the Medicaid Adult Dental Coverage Checker. CareQuest Institute for Oral Health. (2023, June).
   https://www.carequest.org/sites/default/files/2023-06/CareQuestInstituteCoverage.pdf}