The new year means new dental benefits for adults on Medi-Cal.
The state legislature cut back on dental coverage for Medi-Cal patients in 2009 during the Great Recession. Lawmakers brought back some, but not all coverage, in 2014.
The budget passed last year restored all dental benefits. The state will once again cover things like deep cleaning, root canals, implants and partial dentures for those who qualify.
Dr. John Luther, chief dental officer for Western Dental, sees the change as a victory for patient health and as a better use of state funding on health programs.
With all dental coverage restored, more people will get routine exams and have "continuity of care," he said. "So they’d be receiving more preventive services and less very expensive restorative services, improving the health of the patients over time and reducing the costs to the state and to taxpayers."
Luther points in particular to the importance of addressing gum disease with periodontal scaling and root planing.
"If you don’t treat gum disease and restore the teeth, it’s like fixing a roof on a burning building," he said. "You haven’t addressed the underlying disease."
One challenge that remains is that there are not enough dentists who accept patients on Medi-Cal.
"It is very, very difficult for many dental providers to provide these benefits on a large scale because of the low compensation," said Luther.
In an effort to persuade more dentists to accept Medi-Cal patients, the legislature raised reimbursement rates for providers last year. But California’s rates are still lower than they are in much of the country.
Still, "we’re hoping that other dentists in the community—now that benefits are reinstated—also start seeing adults in the population, so there isn’t a bottleneck in terms of treatment," Luther said.
Some have raised another concern: If Congress fails to renew the Children's Health Insurance Program before funding runs out in about three months, California will have to backfill a multibillion-dollar shortfall in Medi-Cal. The California Dental Association has expressed concern that could lead lawmakers to cut back again on dental benefits and/or reimbursement rates.
For Luther, that would mean a major setback for patients who need continued dental care.
"If the program doesn’t have continuity these [improvements] never have a chance to really happen in the state," he said.
This story has been updated for clarity.