Guest Post: Virginia Medicaid has the Opportunity to Provide True Comprehensive Care by Including Dental Coverage

The following guest post is written by twelve health philanthropies from across Virginia. It is the first time these organizations have spoken out on a policy issue.

It may surprise you to know that one of the biggest unmet needs in Virginia is dental care, but it doesn’t have to be. Dental care is not a luxury. Poor oral health can make it impossible to control diabetes. It is associated with chronic heart disease and high blood pressure.  It can significantly impact the effectiveness of treatment for kidney disease. Poor oral health also impacts employability and productivity.

The good news is that we have an opportunity now to help low-income Virginians gain access to this fundamental care by adding a comprehensive dental benefit for adults to the state’s Medicaid program. This will improve health and save money. According to a report by the American Dental Association's Health Policy Institute, after its third year of implementation, an adult dental benefit will save the Commonwealth nearly $14 million dollars.

This can’t happen soon enough. Dental services are among the most expensive primary care services to provide, and subsequently one of the most costly types of services for which individuals pay for. This helps explain why 50 percent of Virginia adults have put off needed dental care because of cost.

Because the state’s Medicaid program does not cover comprehensive dental services for enrolled adults, the responsibility to provide oral health care falls to charity programs and our state’s safety net clinics. Neither can sufficiently address the overwhelming need, and both contend with huge waiting lists and, in many cases, can only offer a limited set of services.

Adults in need go without care – living with daily pain and discomfort -- or they seek relief in hospital emergency departments. Last year alone, Virginia Medicaid beneficiaries sought dental care in emergency departments nearly 20,000 times. These visits typically cost eight times more than visiting a dentist for non-emergency care. They often result in an unending cycle of prescriptions for antibiotics and opioids, putting patients at risk for opioid overuse or abuse.

We write as leaders of health foundations that work throughout Virginia to improve the health of our communities. We do this, in part, by helping fund our state’s safety net clinics and direct-care programs that serve vulnerable Virginians. We are incredibly proud of the organizations and programs we support and know that they offer critical services to patients throughout Virginia. While we rarely weigh in on state issues, we would be remiss if we did not help to amplify the voices of our grantee organizations and those they serve.

Safety net clinics and charity programs, even with our support, do not have the resources to meet all oral health needs of the communities they serve. The status quo has not and cannot produce total health for all Virginians. Our grantees tell us repeatedly that lack of access to dental care exacerbates chronic disease and overall health inequities, and that dental services are among their patients’ greatest needs. The most logical and cost-effective way to meet this need is that dental services be included as part of comprehensive health coverage in Medicaid.

Meeting the Needs of Virginians

In 2018, Virginia expanded access to Medicaid through broader eligibility guidelines -- an action that has enabled more than 383,000 Virginians to obtain health care. The result has been overwhelmingly positive. Virginians who have gone without health care are now being treated for multiple health issues such as high blood pressure, diabetes, and substance use disorder. Yet without access to dental services, a critical piece of the treatment puzzle is missing.

Sixty-five percent of new enrollees cite dental as their biggest unmet need; a need that is described as overwhelming by our grantees. Medicaid expansion has done great things to improve the health of vulnerable Virginians, but without coverage for dental services, low-income and other vulnerable Virginians simply cannot achieve total health.

We take our charge to improve the health of our communities seriously, and we will continue to do everything possible to ensure Virginians have access to the health services they need. This is a critical opportunity in time to support improved health outcomes, promote employability, and save the Commonwealth money. Let’s not let it pass us by.

Signed,

Annette Beuchler MBA FACHE
President and CEO
Obici Healthcare Foundation

Clark Casteel
President  and CEO
Danville Regional Foundation

Christy M. Connolly
President and CEO
PATH Foundation

Mark D. Constantine PhD
President and CEO
Richmond Memorial Health Foundation

Todd Graham
President
The Cameron Foundation

Denny Huff
Executive Director
Bedford Community Health Foundation

Shari Landry
President
Culpeper Wellness Foundation

Susie Lee
Executive Director
Potomac Health Foundation

Patricia N. Mathews
President and CEO
Northern Virginia Health Foundation

Deborah D. Oswalt
Executive Director
Virginia Health Care Foundation

Xavier R. Richardson
President
Mary Washington and Stafford Hospital Foundations

Carol L. Sale, RN, MSN
President and CEO
Williamsburg Health Foundation