This legislative session has seen a groundswell of support to add a comprehensive dental benefit for all adults enrolled in Medicaid. Statewide advocacy organizations, safety net clinics, and medical and dental providers have all advocated for a dental benefit. While the majority of decision-makers agree that oral health services are an important part of overall health, the cost of the benefit is often cited as the main barrier to adopting it. To address this issue and demonstrate the subsequent cost savings that occur when a dental benefit is included in state Medicaid programs, the American Dental Association’s Health Policy Institute has created a Virginia-specific report: Estimating the Cost of Introducing Comprehensive Adult Medicaid Dental Benefits in Virginia.
Of note, a Medicaid dental benefit will:
- Generate cost savings: The HPI report estimates nearly $14 million saved in medical costs by the third year of implementation. This stems from reduced emergency department visits and improved health outcomes for health conditions like diabetes.
- Increase capacity: Because a dental benefit would allow providers to bill Medicaid for oral health care, Virginia’s free clinics and FQHC’s would be able to offset operating costs and see more dental patients. Virginia’s current safety net system is overburdened because of the amount of need in Virginia’s communities.
And it will be paid for predominantly with federal dollars:
Year One Costs for an Adult Dental Benefit in Medicaid
- $17,486,839* – General Funds
- $46,803,011 – Non-General Funds (Federal money)
Year Two Costs for an Adult Dental Benefit in Medicaid
- $25,304,935 – General Funds
- $67,727,915 – Non-General Funds (Federal money)
The Health Policy Institute (HPI) is a trusted national resource concerning key issues related to access to dental care, dental care utilization, and dental benefits. Dr. Marko Vujicic, HPI Chief Economist and Vice President and his team completed their analysis in consultation with the Virginia Department of Medical Assistance Services, using Virginia data where possible and data compiled from other states who have implemented a dental benefit for adults when necessary.
*Current language in the Senate budget allocates $8.7 million in general funds and $23.4 million in non-general funds in the first year of the biennium, because the amendment seeks a start date of January 2021.