The Maine Legislature failed to approve about $6.5 million in state tax funds to establish an adult Medicaid dental benefit, but advocates said they will try again in January, and lawmakers have created a “working group” to study the plan.

Dr. Jonathan Shenkin, past president of the Maine Dental Association, said while he holds out hope for 2020, it was disheartening to see the bill unfunded after an active legislative session. Democrats hold majorities in the state House and Senate and control the executive branch with Gov. Janet Mills. Mills has signaled she would support a “financially responsible” expansion of dental benefits.

“It was very disappointing that we didn’t fund it in a fiscal year when we appeared to have the resources to do so,” Shenkin said. “We know there’s a tremendous need. We believe it’s imperative to have a comprehensive dental benefit.”

More than 70,000 Mainers would gain dental coverage under an adult Medicaid benefit, and Maine would join 33 states, plus the District of Columbia, that have adult Medicaid benefits. Low-income children are already covered by Medicaid nationwide, but dental care for adults is considered optional, and states can opt into providing the benefit.

Maine currently only pays for adult dental care under Medicaid for emergencies, such as an infection that requires an emergency room visit. Health care advocates contend that over the long term, preventing oral disease saves the health care system money.

“Medical research shows that poor oral health results in increased risk for diabetes, breathing disorders, cardiovascular disease and poor pregnancy outcomes such as preterm births and stillbirths,” says the Pew Charitable Trusts, a nonprofit policy think tank.


The federal government would pay for most of the benefit, about $17.2 million, with the state chipping in $6.5 million for about 70,000 Mainers to get dental coverage, according to state estimates. Mainers who earn up to 138 percent of the federal poverty level – $34,638 for a family of four – are eligible for Medicaid and would be covered for dental care.

Alison Weiss, communications director for Maine Equal Justice, a nonprofit advocacy group for low-income Mainers that lobbied in favor of the legislation, said that they believe the bill has a good chance in 2020, with a supportive Legislature and a governor who has funded several other health care priorities.

“There were many good ideas this session that had a lot of support that did not get funding,” Weiss said. “There’s a growing awareness of the incredible need. We are well positioned for next year.”

Shenkin has also pointed out that reimbursement rates for Medicaid patients need to be competitive. The reimbursement rate for pediatric dental work in Maine is 44.6 percent of what a commercial plan would pay.

Sass Linneken, 41, of Winthrop said while she has dental insurance now, she wishes she had dental insurance in her 20s and 30s, when she had very low income and was homeless at times. Most of her teeth had to be extracted, and she has $6,000 in credit card debt related to dental problems. She said she had to go to the emergency room several times for tooth pain.

“If I had had dental insurance, I would have had it taken care of, because I was basically having tooth pain all of the time,” Linneken said. “My teeth were in such bad shape.”


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