Delegate, dentist working to restore adult dental benefits through Medicaid

Among those participating in a recent meeting in Annapolis to discuss implementation and funding of a Maryland adult dental Medicaid benefit are, from the left, Robyn Elliot, Maryland Dental Action Coalition; Dr. Diane Romaine, president, Maryland State Dental Association Foundation; Lt. Gov. Boyd Rutherford; and Del. Mike McKay.

CUMBERLAND — Ashley Cline is leaving one struggle behind to take on a new one. 

After years of drug abuse, her teeth are decayed. In recovery for nearly five months, she works a minimum wage job, but can’t afford to fix them, and her Medicaid program has limited coverage for fillings, she said.

Now Cline may be forced to look for a community-based charity program to help pay for her bottom teeth to be extracted, something that concerns the 32-year-old, after having her top teeth removed and replaced with a plate a few years back.

“Not everyone wants to get their teeth pulled out if they can be saved,” she said.

Even if Cline is forced to have extractions, she doesn’t see much hope if her teeth are pulled out. The late Dr. Alan Porter of Flintstone helped Cline out by charging $350 for the plate instead of more than $1,000, she said. 

“I can’t afford, on my income, to go and buy a plate from a dentist,” she said. 

“Alan Porter, as opposed to charging 12- or 15-hundred dollars, he was only charging $350.”

Medicaid, a national insurance program offered to low-income adults, children and the disabled, has restrictions when it comes to dental care. 

After an infection from an abscessed tooth killed 12-year-old Prince George’s County resident Deamonte Driver in 2007, Maryland began offering full dental coverage to children under 18 in 2012. 

However, Maryland adults and the disabled are not so lucky. District 1C Del. Mike McKay and local dentist Dr. Diane Romaine are working to change that. 

“Maryland can actually save money by reimplementing an adult Medicaid program,” Romaine said.

McKay introduced legislation during the 2017 General Assembly session to establish a dental care program for adults. Not only is dental care essential to an individual’s overall health, he said, but it would save the state money in the long run.

And it would also cut down on opioid prescriptions.

According to Romaine, a 2014 study revealed $21 million in Medicaid funding was spent on emergency room visits for adults suffering from dental pain due to rotted teeth. That’s money that could have gone toward prevention, rather than opioids and antibiotics, Romaine said.

“That $21 million did not pay for one cleaning, one extraction or one filling,” she said. “It paid for opioids and for antibiotics. That is not a very prudent use of funds, whatever side of the political spectrum you are on. You don’t want to see money wasted.

“You’re spending the money already, so is there a way to spend it more prudently, thus reducing opioids, thus giving people definitive dental treatment and thus making them healthier?” Romaine said.

McKay’s legislation was successful, but the funding needed for the program to get off the ground has yet to be implemented into the fiscal year 2019 budget. Romaine said giving adults about $1,000 in dental coverage beginning in January 2019 would cost the state about $15 million. 

If implemented, the program would cover the basics when it comes to adult dental care — services like cleanings, fillings and extractions. The state children’s program is all-inclusive, even offering braces, and costs the state about $168 million annually. Since implementing the dental plan for children, the state has saved significantly on emergency room costs for anyone under 18, as adult visits continue to climb, Romaine said.

Romaine is hoping to manage a small portion of funds for adults to have some coverage.

“The wild card is Gov. (Larry) Hogan can still say ‘Well, sorry guys, I’d love to do it, but I don’t have the money’ — he has that level of power,” she said. “Everybody can say we want to do it, but until it is in the budget, funded, it doesn’t become a reality.”

As for Cline, she just wants to start the next chapter of her life, smiling.

“When you get clean it does help your self-esteem,” she said, “but when you have setbacks like this, it brings you down.”  

Follow staff writer Heather Wolford on Twitter @heatherbwolford.

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