Virginia budget negotiators preserve adult Medicaid dental benefit

Virginia budget negotiators preserve adult Medicaid dental benefit
The Virginia House of Delegates begins their special session inside the Siegel Center in Richmond, VA Tuesday, August 18, 2020. (Source: (Bob Brown/Richmond Times-Dispatch/Pool))

Virginia’s pared-down state spending plan retained one major priority for health advocates — a dental benefit for adult Medicaid patients.

General Assembly budget negotiators restored roughly $17.5 million in state funding to implement the coverage by July 1 next year. The two-year spending agreement, announced Wednesday afternoon, still has to go for a final vote before state legislators — and be signed by Gov. Ralph Northam, who can veto or request changes to specific spending items.

But safety net providers and advocates for low-income patients were optimistic that the dental benefit — “long overdue in Virginia,” according to Thomas Wilson, executive director of the Northern Virginia Dental Clinic — would pass after more than two decades of activism.

“When I got here 24 years ago, Virginia was one of only seven states that never had a dental benefit in its Medicaid system,” added Wilson, whose clinic serves adults in Northern Virginia with an income at or below 200 percent of the federal poverty level. “So, it’s about time we step up and provide that.”

Currently, the state offers comprehensive dental coverage to pregnant women and children until they reach the age of 20. But without an adult benefit, hundreds of thousands of Virginians are left with plans that cover nothing except emergency extractions.

Providers say the system creates huge problems for patients and for medical spending. Without preventive treatment, easily treatable problems, such as cavities, can spiral into major health concerns. Wilson said many of the patients seen at his clinic have received multiple extractions from years of poor oral health. Others have coexisting conditions, including diabetes, which can be exacerbated by dental issues. Gum disease, for example, can make it harder for the body to regulate blood sugar, and diabetes can also increase the risk of tooth infections and other oral health issues.

“That’s part of the problem — it becomes systemic,” Wilson added. Many medical groups have argued that the expanded benefit could help reduce overall health spending by improving chronic disease outcomes.