Medicaid dental coverage is first to go when states can't tighten eligibility rules; has big rural impact

Many states have cut optional benefits for poor adults enrolled in Medicaid, rather than tighten eligibility requirements at a time when more people need the program, and dental services are often first to go. The problem likely won't improve under President Obama's health-care overhaul because it requires dental coverage just for children. The cuts probably affect rural residents disproportionately since many rural places are facing dentist shortages, according to the Pew Center on the States.

In about half the states, Medicaid dental care now covers only pain relief and emergencies, according to a recent Kaiser Commission on Medicaid and the Uninsured report. Other states cover preventative exams and cleaning, but not fillings and root canals, Abby Goodnough of The New York Times reports. Some states are also cutting vision, chiropractic and podiatry coverage, and requiring co-payments for prescription drugs. (Times photo by Gretchen Ertl)

Many adults on Medicaid are turning to community health centers for dental care. In Massachusetts, which has long been a state with very generous Medicaid, community clinics received 22,000 new dental patients in the first six months after dental coverage was dropped. And in states where Medicaid still covers dental care, "finding dentists who accept Medicaid can be next to impossible," Goodnough writes, because reimbursements have also been cut and dentists have dropped out of the program or refuse to join. (Read more)