Kids on Medicaid Not Getting Dental Care

Medicaid is supposed to help families take care of medical and dental needs, and this is especially important for children.  A recent study by the United States government revealed that millions of poor children on Medicaid are not getting the dental treatment they need because they cannot find dentists willing to accept Medicaid as payment.

This leaves many children in a very vulnerable state.  The findings, released by the Government Accountability Office stated that millions of poor children between the ages of 2 and 18 have untreated dental decay and disease because they cannot get the needed treatment.

It might not sound like a huge issue to have a cavity that doesn’t get taken care of, but think about whether you have ever had a toothache that grew worse and worse over a weekend.  When you went to the dentist you discovered that you had a cavity that, if it had been addressed sooner, could have been filled.  The dentist feels that you now need a root canal or other serious procedure because the cavity has destroyed too much of your tooth and that is what is causing your pain.

Now think about a child or young adult who has not one but 5 or 10 of these festering in their mouth.  They are in pain.  They probably are not able to eat right.  Perhaps they cannot concentrate – especially in school – because of the pain and headaches due to the dental problems.

If they –or their parents – are conscientious about brushing, flossing and rinsing with mouthwash, they may avoid infection.  If not, like 12 year old Deamonte Driver, even though they try to do everything to keep the condition under control, they are unable to.  In Deamonte’s case, he ended up with a serious tooth infection that led to a brain infection and he died.

Deamonte had Medicaid coverage.  He had a simple cavity.  His mother tried to find a dentist – any dentist – that would help him and treat the condition while it was a simple situation and no dentist would do so because they would not accept Medicaid as payment.  Because of a few more dollars, 12 year old Deamonte is dead. 

Only 1 out of 3 children on Medicaid are receiving dental care, mainly because nobody will provide it.  It is essential that while lawmakers are looking at a Medicare fix, they look at Medicaid, as well.  It is also essential that practitioners, schools, lawmakers and Medicaid work together to fix this problem.  2 out of 3 children on Medicaid that cannot find dental care should not remain vulnerable to the unconscionable outcome that Deamonte Driver and his family suffered.

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Both Sides of the Medicaid Financial Debate

Many states do a poor job of regulating Medicaid fraud because it is a not a simple matter economically.  After all, for ever dollar Medicaid brings into a state, there is a federal matching dollar hat the state receives.   Some states even overpay Medicaid providers, collect matching federal funds, and collect kickbacks of overpayments, thus becoming part of the fraud problem.

The question then becomes, what is the sense behind turning the oversight of Medicaid over to the same government that is participating in the fraud?  Their actions have created long waiting lists, rationing of care and poor delivery of not enough care, again controlled by the government.

There is another side to the issue, however.  What happens when you need to make the numbers work?  It’s important to look at the major problem.  There are many honest and caring physicians who try to help as many individuals on Medicaid as possible.  The problem is that even the busiest physicians that take Medicare can’t take more than about 28% of their caseload in Medicaid patients, they can’t afford to stay in business because the amount they are reimbursed is lower than the services provided.  Therefore, if there are too many Medicaid patients seeing a particular doctor, he loses money until he can’t afford to stay in business any more.

We haven’t even talked about the number of children covered by Medicaid for various reasons.  There are over 25 million kids that have various forms of Medicaid coverage.  There are Targeted Case Workers and Case Management through Medicaid Rehabilitative Services who do all they can to deal with children’s’ physical and mental disabilities – getting help and services for them while keeping expenses to Medicaid and to physicians under control.  A federal-state partnership that exists now to cover these expenses could be eliminated if some politicians get their way. 

Looking at both sides, the hope is that the politicians will be able to work with the expenses while remembering that these issues are not only about finances, but at the heart of the issues are children and adults with vulnerabilities and disabilities that depend on the Medicaid system to help keep them well.     

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