Medicaid Enrolled Children Have More Untreated Tooth Decay

Ruzanna Harutyunyan's picture

Children covered under Medicaid receive considerably less dental care and have more untreated tooth decay than those who are privately insured, witnesses testified during a recent hearing held by the House Oversight and Government Reform Domestic Policy Subcommittee, CQ HealthBeat reports. According to CQ HealthBeat, a Government Accountability Office report released last month found that an estimated 6.5 million children covered by Medicaid had untreated tooth decay in 2005.

Alicia Cackley, acting director of health care at GAO, in written testimony said that children covered by Medicaid between 1999 and 2004 were almost twice as likely to have untreated tooth decay. She added that 15% of children in Medicaid had difficulty receiving dental care because the provider did not accept their insurance plan, compared with 2% of privately insured children.


James Crall, director of the National Oral Health Policy Center at University of California-Los Angeles, said "chronically low" reimbursement rates discourage many dentists from participating in the program. He added that increases in provider reimbursement have increased the rate of children covered by Medicaid using dental services in several states. He also suggested streamlining provider enrollment and separating dental benefits from the rest of the Medicaid program to "allow states to retain greater control in setting reimbursement rates, and allow for reasonable profits on the part of the dental benefits managers while eliminating the incentive to reduce payments to dentists who provide dental services to Medicaid beneficiaries."

Witnesses from several states testified that raising reimbursement rates, streamlined enrollment procedures and improved outreach programs have increased access to dental care for children covered by Medicaid. Herb Kuhn of CMS said the agency has completed reviews of 17 states with low dental utilization rates and will release the findings in a national report. He added that the agency wants to improve access to dental care, reimbursement rates for providers and evaluations of which services are provided (Straus, CQ HealthBeat, 10/3).

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