The Maryland House of Delegates is set to consider a bill to establish a pilot program to provide dental insurance for Medicaid recipients, the first step toward what some lawmakers hope will be a plan to deliver extensive coverage to those with the most serious dental conditions.
The dental insurance bill, which passed the Senate unanimously Monday night, has been scaled back from legislation originally submitted by Sen. Thomas M. “Mac” Middleton.
The initial legislation sought to provide full-scale adult dental coverage for Maryland residents eligible for Medicaid. The Charles County Democrat said the bill has been amended to launch a test program under which some of the most critical dental procedures would be covered.
The Maryland Dental Action Coalition, a group of health advocates that supported the original bill, welcomed the smaller step. The coalition issued a statement calling it “a huge victory that brings us one step closer to adult dental coverage in Medicaid.”
Maryland children already receive dental coverage under Medicaid.
Middleton said the pilot program will focus on patients who have diabetes, which can lead to dental conditions that can escalate into serious health problems.
“When they show up at the emergency room, they are serious patients and they’re going to end up in the hospital,” he said.
Middleton, chairman of the Senate finance committee, said he backed off the broader bill because of concerns about costs. He said he worked with Health Secretary Robert R. Neall on crafting the amended proposal.
Medicaid in Maryland covers the cost of an emergency room visit to treat oral infections or pain but not the cost of dentistry to prevent or fix the underlying problems. Health care advocates plan to push legislation in the current General Assembly session to close that coverage gap.
Health Department spokeswoman Brittany Fowler said the agency has not reached an agreement with Middleton but said the amended bill will cost much less. The department plans to conduct a cost-benefit analysis and find “the right fit“ for Maryland residents, Fowler said.
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The bill gives the department wide discretion to define whom the program will cover and where it will operate.
The original legislation would have cost $15 million in state funds for the budget year starting July 1, 2019, rising to $35 million by July 2022, according to the Department of Legislative Services. Budget analysts said the program would bring in roughly $2 in federal funds for every state dollar spent.
Analysts have not yet worked up a new estimate for the pilot program, but it is expected to cost much less. Only patients for whom the state can obtain matching federal funds will be eligible under the pilot.
Before Maryland can launch its pilot program, it will need to receive permission from the federal government, Middleton said.
While he settled for the pilot program this year, Middleton said he still hopes to eventually extend full dental coverage to Medicaid patients. He expressed confidence that the pilot program will demonstrate that up-front coverage of dental conditions would prevent more serious illness.