July 19, 2018
In a surprise reversal, Kentucky officials will announce Friday that the state will rescind Medicaid cuts that eliminated dental, vision and non-emergency transportation services for nearly 400,000 Kentuckians, according to several sources familiar with the change.
The sources asked not to be identified because they are not authorized to comment publicly.
The administration of Gov. Matt Bevin did not immediately respond to a request for comment.
The abrupt cuts effective July 1 caught patients and providers across Kentucky off guard and caused the most disruption in dental services. Some dentists were forced to turn away hundred of patients who had lost benefits overnight.
The swift reversal of the cuts comes as providers are still trying to adjust to the cuts and inform patients about what’s going on.
{Dentists told the Courier Journal they had to cancel appointments for patients who had waited months for relief from decayed teeth and abscessed gums, some in need of what dentists call “full mouth extractions.” They said patients showed up with no idea they had lost Medicaid dental coverage and were upset and angry.}
Kentucky dentists say the Medicaid dental cuts could have been catastrophic in a state with high poverty and some of the nation’s worst oral health, especially in Eastern Kentucky.
“This is a big problem,” said Dr. Chad Street, a Pikeville oral surgeon who has had patients wind up in intensive care from dental infection that spread through their bodies. “Patients are going to be in pain. Patients are going to end up in the hospital or in the worst case scenario, die from infection.”
Some patients found their benefits cuts while they were in the middle of treatment, including Susan Wells, of Louisville, who had been having decayed teeth extracted when the cuts were announced.
She had five teeth left to pull when the state announced it was eliminating dental services for the “able-bodied” adults, mostly those among about 500,000 people added Medicaid under the Affordable Care Act.
“When that came up, I said ‘I might as well die,'” said Wells, 51. “I cried. I was so angry.”
Wells got the care she needed on July 11 through Shawnee Christian Healthcare Center, a nonprofit clinic in West Louisville that decided, for now, to continue to treat its Medicaid dental patients regardless of whether they can pay.
State Medicaid officials told a legislative committee the changes left around 373,000 people with no routine dental or vision coverage.
The cuts came two days after a federal judge struck down Bevin’s plan to overhaul Medicaid, adding work requirements, premiums and other rules. The plan would have placed about 460,000 “able-bodied” adults in an plan with more limited benefits that did not include dental and vision services though individuals could earn points toward paying for such care through activities such as on-line classes or volunteering.
The Cabinet for Health and Family Services said in the July 1 statement that immediate cuts in dental, vision and transportation benefits were required “to compensate for the increasing costs of expanded Medicaid” and were “an unfortunate consequence of the judge’s ruling.”
Health law advocates and an outside expert say the June 29 ruling by U.S. District Judge James E. Boasberg, of Washington, D.C., does not require any such cuts.
“There is nothing stopping the state from continuing to offer dental and vision as they had done,” said Marybeth Musumeci, a lawyer and Medicaid expert with the Kaiser Family Foundation, a nonprofit health policy organization.
By Deborah Yetter
Louisville Courier Journal