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Pennsylvania looks to add extensive dental care to Medicaid, again

  • Ben Wasserstein/WITF
The Capitol building in Harrisburg on Oct. 12, 2023.

 Jeremy Long / WITF

The Capitol building in Harrisburg on Oct. 12, 2023.

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Lawmakers are looking to reinstate most forms of dental care to Medicaid.

In 2011, changes to the state’s Medical Assistance program, which helps low-income Pennsylvanians pay for their medical expenses, eliminated much of the coverage toward dental care.

As a result, procedures such as root canals were not covered unless the patient had an approved exception. 

This meant they could get coverage only if they had a serious health condition.

In both chambers, legislation has been introduced to reinstate the assistance toward dental care.

Sen. Jay Costa, D-Allegheny, is the prime sponsor of the Senate’s bill. He said it is important to assist with dental care so people can get treatment as soon as possible in order to get ahead of potentially life-threatening ailments.

“Things that start out as dental problems manifest themselves into physical health problems, which ends up in the emergency room or even hospitalization,” he said.

Providing dental treatment early could also save the state money as it won’t divert the funds toward costlier treatments.

“We put these resources out today for dental care [and] over the course of years, it saves a lot of money because you’re avoiding having folks show up in the emergency room in conditions that are far worse,” Costa said.

Complications from gum disease can also lead to a high risk of diabetes, said Helen Hawkey, executive director at the PA Coalition for Oral Health.

“When people don’t have healthy mouths because they have gum disease that’s not controlled,” Hawkey said.

Though the bill has only Democratic sponsors in a Republican-controlled Senate, Costa said he believes it will pass.

An unintended consequence of canceling coverage is dental schools lowering the requirement to graduate as Medicaid patients are used to help train dentists, Hawkey said.

“Instead of doing maybe eight crowns in order to graduate, they only have to do one cap or crown before they graduate,” Hawkey said. “So we’re also graduating dentists that aren’t getting enough clinical skills experience before they’re kind of going out into the state and it just makes it really, really hard.”

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