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This video was made following the cuts made in 2009 by the MN legislature.
The HelpMNSmile campaign strives to improve access to dental care for all Minnesotans and improve the health and wellness of those most at risk. Minnesota’s adult benefit set was cut in half during the 2009 legislative session after a difficult budget year. These cuts resulted in a lower standard of care and the elimination of essential services.
While the cuts eliminated many services and put restrictive limitations on what was covered, it also eliminated one of the major diseases of the mouth. There are two major types of diseases of the mouth – tooth decay and periodontal disease. Currently, the state Medicaid program only covers treatment for tooth decay. When left untreated, people are at risk for further health issues including increased risk of health disease, stroke, diabetes, and even preterm labor.
As noted by the Surgeon General (2000), “A thorough oral examination can detect signs of nutritional deficiencies as well as a number of system diseases, including microbial infections, immune disorders, injuries, and some cancers.” (Link)
Minnesota is once again facing an estimated $1.27 billion dollar deficit, not taking into account inflation. Legislators will have to make difficult decisions during the 2021 legislative session to balance the budget. The HelpMNSmile coalition believes that cutting what little remains of the adult dental benefit set is not the answer.
What is oral health? According to the Surgeon General (2000) oral health means much more than healthy teeth. It means being free of chronic oral-facial pain conditions, oral and pharyngeal (throat) cancers, oral soft tissue lesions, birth defects such as cleft lip and palate, and scores of other diseases and disorders that affect the oral, dental, and craniofacial tissues…These are tissues who functions we often taken for granted, yet they present the very essence of our humanity. They allow us to speak and smile; sign and kiss; smell, tase, touch, new, and swallow; cry out in pain; and convey a world of feelings and emotions through facial protections.” (Link)
The mouth is an essential part of our overall health.
HelpMNSmile believes that continuing to invest in adult dental coverage and providing necessary treatment for individuals with special needs will help save taxpayer dollars. It will ensure the correct use of health care dollars by decreasing unnecessary ER visits and preventing complex health issues. From 2016 to June of 2018 it is estimated that $49.48 million was spent on non-traumatic dental care in Emergency Rooms (MN Hospital Association).
On average the cost of a visit to the Emergency Room for dental care is $861. Average charges for dental visits are increasing twice as rapidly as non-dental Emergency Room average charges. Any additional cuts to the program will only exacerbate the problem. Minnesota legislators can take steps to stop the increasing Emergency Room costs to the state by supporting expanding the adult dental benefit set to include treatment for periodontal disease or a full reinstatement of the adult dental benefit set.
Supporting Help Minnesota Smile means protecting and improving access to critical dental care services across Minnesota and at a minimum preserving the current standard of care.
In 2009 the Minnesota legislature cut the adult dental benefit because of a budget deficit. Under the current law, Minnesotans on Medical Assistance can receive limited care. Low income adults in the state are most likely to report having problems due to the condition of their mouth and teeth, with the top issue they are experiencing is pain (Health Policy Institute, 2015).
The current statute does not allow full-mouth x-rays to be taken. Full-mouth x-rays are necessary for a proper diagnosis of a patient’s oral health. Instead, Medical Assistance only covers bitewing x-rays and a certain number of periapical x-rays, which must be done together in order to get a correct diagnosis. Combined, bitewings and periapical x-rays cost the state more money than if they covered a set of full-mouth x-rays.
Under the current statute, medical assistance will provide coverage for only one of the two major types of mouth diseases – tooth decay. But individuals with periodontal disease are unable to receive the care that they need.
Why cutting adult dental isn’t the answer to saving money.
Minnesota is not the only state that has cut or eliminated their adult dental benefit set. At the same time that Minnesota cut their adult dental benefit set, California eliminated theirs entirely. The cut resulted in more than 1,800 additional dental visits to the emergency room a year (Health Affairs, 2015). Massachusetts studied the effect of major cuts to their program in 2002 and 2003 and found that more individuals were “living with pain, diminished self-esteem, and negative effects on employment and their families’ financials due to dental problems.” (Kaiser Study)
While cutting the adult dental benefit set might appear to save the state money, those individuals will still need care and will seek it out at emergency rooms. Not only are non-traumatic dental care visits to the ER expensive for the state, but emergency rooms lack the dental staff and are unable to adequately treat these individuals. Often, these patients are given a prescription for antibiotics or pain killers and told to see a dentist. Untreated oral health needs can result in more complex issues which only increases the cost of care that is required to help these patients. Cutting adult dental would put some of our most vulnerable, including elderly and adults with disabilities, at risk of having unmet dental problems.
Preserving the limited adult dental benefit set Minnesota currently has, will ensure that these individuals can continue to access their dentist. Having a program that enables patients to get preventative care can significantly help reduce overall healthcare costs and improve health outcomes.
Patients on Medical Assistance can receive a comprehensive exam once every five years from their dentist. But if they switch providers within those five years, Medical Assistance will not cover a comprehensive exam by their new provider, even though it is essential for a proper diagnosis and to develop a thorough treatment plan.
The HelpMNSmile coalition still believes that Minnesota can improve access to dental care by reinstating the adult benefit set to what it was before the cuts in 2009. However, given the current budget shortfall the coalition understands that the state is not in a strong position to do so. The coalition is advocating for, at a minimum, not making additional cuts to the benefit set. The coalition will also continue to support opportunities to improve the adult dental benefit set.
Despite the current budget deficit and the coalitions focus on preserving what is currently covered under state law, the HelpMNSmile campaign’s ultimate goal is still working to reinstate the adult dental benefit set that was in place before 2009. What would this mean? Dentists would be able t provide the care these patients actually need.
Medical Assistance does not cover root canal treatment for posterior teeth. So, an otherwise salvageable tooth must be extracted instead of saved by proper treatment. This can lead to difficulties for a patient such as not being able to chew food properly.
You Can Help
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