Lawmakers are considering a bill that for the first time would provide limited access to dental care for adults who receive MaineCare benefits, a proposal designed to reduce uncompensated emergency room treatment for dental pain.
Maine currently does not provide an adult dental benefit to MaineCare recipients, although children are covered. About 25 states provide at least some dental coverage for adults on Medicaid, the federally funded program that operates in Maine as MaineCare.
Under a proposal by Rep. Drew Gattine, D-Westbrook, if a medical doctor signs off on the need for dental care, an adult MaineCare recipient could visit a dentist and have the work paid for by MaineCare, rather than waiting for the problem to become so acute that it results in a visit to a hospital emergency room.
“This is not intended to provide a full array of MaineCare dental services for adults,” Gattine said. “It’s not just for people who haven’t had a cleaning in a while and want to have a cleaning.”
Rather, Gattine said, if a medical doctor sees obvious signs of tooth decay or an abscess, the MaineCare patient can be sent to a dentist rather than having to go to the emergency room.
In many states, more than 35 percent of all emergency room visits are due to dental problems, according to a 2010 study by the Pew Center on the States.
In 2006, about 8,500 emergency room visits by MaineCare patients ages 15 to 44 were triggered by dental pain, according to a 2010 study by the Muskie School of Public Service at the University of Southern Maine. The study did not specify what percent of total emergency room visits this represents.
The Maine Dental Association supports Gattine’s bill. Dr. Jonathan Shenkin, an association representative, said anything that helps adults get needed dental care is a plus for Maine.
“The real crisis in our state is adults who can’t afford care,” Shenkin said.
The Legislature’s Office of Fiscal and Program Review has yet to estimate the cost of the bill, which will likely be an important factor in how lawmakers react to it.
The Legislature’s Health and Human Services Committee held a public hearing on the measure last week, and the panel has scheduled a work session for this week.
Stefanie Nadeau, director of MaineCare services for the Department of Health and Human Services, testified against the bill at last week’s hearing, arguing that it could be expensive and its costs would be difficult to forecast accurately.
“The department is concerned about the expansion of services and the inability to project the true cost of these additional services,” Nadeau said. “We cannot assume that this expansion of adult dental coverage would result in a corresponding reduction in emergency department dental costs, and do not believe that any immediate cost reductions would offset the additional expense of adding this service.”
The bill does say that “preventive” dental care would be covered, although Gattine said that’s not the intent of the bill. Gattine said he would be willing to amend the bill’s language to address concerns that MaineCare would pay for dental care beyond the bill’s intent.
Gattine said he supports the eventual goal of providing a more expansive dental benefit to adult MaineCare patients, but he does not believe such a major change to MaineCare would be approved at this time.
Also before the Legislature are attempts to increase MaineCare reimbursement rates for dentists and a controversial bill that would allow dental therapists to practice in Maine. Dental therapists would be a mid-level provider, similar to a nurse practitioner for doctors.
Joe Lawlor can be contacted at 791-6376 or at: