It's true, as a recent article in The Bellingham Herald so effectively described, that restoring low-income adult dental coverage in Washington would ease pain and suffering, reduce impacts on emergency rooms and community health centers and save money.
Still, many people may not realize how much savings and what significant improvements in health and employability this action by the Legislature could generate.
For example, the state could potentially save tens of millions of dollars by restoring dental coverage for low-income adults with diabetes. Poor oral health is linked to diabetes as well as to other serious health issues including heart disease, stroke and pneumonia. In fact, dental disease is often referred to as one of the major complications of diabetes.
When the Legislature eliminated low-income adult dental coverage to help balance the state budget in 2011, more than 450,000 low-income adults lost coverage. Among those affected are estimated 60,000 people with diabetes.
Research has shown however that providing dental treatment to patients with diabetes can reduce the cost of their care by more than $3,200 per person per year, and reduce hospitalizations from diabetes complications by 61 percent in the first year.
To be conservative, if only 25 percent of the patients with diabetes receive dental care through restoration of dental coverage and if the care results in only half of the medical costs savings ($1,600), more than $24 million a year could be saved on medical costs.
People without insurance still need care when the pain from dental problems gets intolerable, so they often head to the emergency room where care is very expensive and costs are often passed on to taxpayers. Over an 18-month period, 54,000 dental-related visits to emergency rooms in Washington cost more than $36 million.
Most emergency rooms aren't even equipped to treat dental issues. They can provide temporary relief from pain and maybe treat an infection, but more than likely the patient will be back when the underlying dental problem flares up again. So restoring adult dental coverage to help deter people from seeking care in emergency rooms can save significant dollars.
The Legislature has both a unique opportunity and an urgent need to act this year because of two converging factors.
First, with Medicaid expanding due to national health care reform, the state will realize an estimated $242 million in savings when the federal government takes over funding of state health care programs. The legislature would need to use only about $15 million of that savings per year to restore dental coverage for the Medicaid-eligible adults who lost it in 2011.
Second, if legislators act this session, the federal government will pay the full cost of dental coverage for all new enrollees through Medicaid expansion, which is projected to be about 250,000 people.
Altogether, the state would be able to provide dental coverage to more than 700,000 low-income people at $21 per person per year - an incredible bargain.
If legislators fail to restore adult dental this year, federal dollars that otherwise would come to Washington will go to other states for their health care needs. Decisive action in Olympia can ensure Washington gets its fair share under health care reform.
There would be many other financial, health and societal benefits from restoring low-income adult coverage. For example, it's been documented that adults who have dental coverage and seek dental care are more likely to ensure that their children receive dental care. Good oral health also makes it easier for adults to get jobs and provide for their families, while poor oral health and rotting or missing teeth can make them less employable and productive.
Restoring dental coverage for low-income adults is clearly the right thing to do. It makes financial sense and is the compassionate, common sense health care imperative for the Legislature to accomplish this session.
ABOUT THE AUTHORS
Larry Thompson is the executive director of the Whatcom Alliance for Health Advancement. Chris Phillips is the director of community affairs at PeaceHealth St. Joseph Medical Center in Bellingham.