Today’s post is written by Mary Boudreau, Executive Director of the Connecticut Oral Health Initiative (COHI), one of CT Health’s oral health advocacy grantees.
This year Connecticut residents had more than Halloween ghouls to be scared of, when Governor Malloy signed a new budget into law on October 31. It will cut more than $120 million in 2018-2019 from the state’s Medicaid program, resulting in potential adverse effects on oral health for 93,700 low-income parents, seniors and people with disabilities.
Let’s look a little more closely at the cuts:
- An annual cap of $1,000 on non-emergency dental care for adults. This cap will affect about 16,200 low-income adults, the estimated number of adults getting dental treatment over $1,000 in a year. They may no longer be able to get complete or comprehensive care. Though some dental treatment can be postponed to the next year, other treatment may be medically necessary and urgent. This will require prior authorization for care costing more than $1,000, which dentists may not know they can request. Advocates also worry that a cap could result in dentists refusing or limiting Medicaid adult patients, because of the additional administrative burden. Indeed, dentists nationwide have cited these burdensome requirements as one barrier to participation.
- HUSKY A eligibility reduction from 155% to 138% of the federal poverty level (FPL). About 9,500 HUSKY A adults, parents, and children’s caregivers will no longer qualify for Medicaid when the current income limit changes from 155% of the FPL to 138%. This will mean, for example, that parents in a family of four earning $37,665 (155% FPL) will no longer qualify for HUSKY A. Only parents in families of four earning under $33,530 (138% FPL) will be eligible. (The eligibility level for children is not affected by this cut.) The legislature and governor expect the affected HUSKY A beneficiaries to purchase private insurance through the Access Health CT, the state’s health insurance exchange. This may be unlikely given the costs of those plans. When parents were cut from HUSKY A two years ago, only 16 percent ended up covered by plans sold through the exchange. Even if those affected by this latest cut purchase private insurance, these plans do not cover dental services.
- Medicare Savings Program eligibility reduction from 246% to 100% of the FPL. The Medicare Savings Program (MSP) gives enrollees some benefits of the Medicaid program, with financial assistance to help pay for lab tests, outpatient hospital care, and doctor visits. Currently, Medicare beneficiaries whose incomes are under $29,225 (246% FPL for a single-person household) are eligible for this assistance through the MSP; those earning less than 211% FPL ($25,067) have also gotten help paying for out-of-pocket expenses such as co-pays, deductibles, and prescription costs. As of January 1, 2018, only people earning $11,880 (100% FPL) will qualify for assistance. This will affect 68,000 low-income seniors and people with disabilities in Connecticut. Advocates worry that having to pay more out of pocket for health care will mean people may be less likely to have additional funds to pay for dental care, which is not included in Medicare.
The consequences of untreated dental disease are costly and dangerous. With these cuts to dental health and general health care, Connecticut’s low-income adults, elderly, and people with disabilities are likely to struggle even more to maintain good oral health. The Connecticut Oral Health Initiative and other oral health stakeholders will continue to work with the Department of Social Services and state and federal legislators to improve Medicaid. Contact us if you want to advocate for oral health for all, maryb@ctoralhealth.org.