Pennsylvania looks to add extensive dental care to Medicaid

  • Ben Wasserstein/WITF

October 12, 2023, Capitol Building, Harrisburg.

Jeremy Long/WITF

October 12, 2023, Capitol Building, Harrisburg.

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Lawmakers are seeking to restore most forms of dental care to Medicaid.

In 2011, changes to the state's medical assistance program, which helps low-income Pennsylvanians pay medical bills, eliminated coverage for most dental care.

Therefore, procedures such as root canals will not be covered unless the patient obtains an approved exception.

This means they can only get coverage if they have a serious health condition.

Both houses have introduced legislation to restore aid for dental care.

Sen. Jay Costa, D-Allegheny, is the lead sponsor of the Senate bill. He said it was important to assist with dental care so people could receive treatment as quickly as possible and avoid potentially life-threatening conditions.

“What started as a dental issue turned into a physical health issue that ended up in the emergency room or even hospitalization,” he said.

Providing dental treatment early also saves the state money because it does not divert funds to more expensive treatments.

“We are dedicating these resources to dental care today [and] It saves a lot of money over the years because you prevent people from showing up to the emergency room in a worse situation,” Costa said.

Complications of gum disease can also contribute to a higher risk of diabetes, said Helen Hawkey, executive director of the PA Oral Health Alliance.

“When people don't have healthy mouths because they have uncontrolled gum disease,” Hawkey said.

Although the bill has only Democratic backers in the Republican-controlled Senate, Costa said he is confident it will pass.

Hockey said one unintended consequence of eliminating coverage is that dental schools lower graduation requirements because Medicaid patients are used to help train dentists.

“Instead of wearing eight crowns before graduation, they only have to wear one hat or crown before graduation,” Hockey said. “So we're also producing dentists who don't have enough experience with clinical skills before coming into the state, and that makes it very, very difficult for them.”

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