House refuses to support Medicaid dental benefits

During the Senate’s nine-hour public hearing on the budget last month, two things dominated the testimony: opposition to divisive concepts and support for Medicaid dental benefits. Divisive concepts passed. Dental benefits appeared to die Wednesday

A joint legislative committee negotiating the final details of the budget agreed to put a “hold” on the Senate’s $1.5 million proposal to provide dental benefits to people on Medicaid and Medicaid expansion after the House refused to support the program. It would have provided dental benefits to seniors, those who are permanently disabled, and people with low incomes. 

A hold is not certain death to legislation, but it’s pretty close.

Rep. Lynne Ober, a Hudson Republican on the committee, said the House did not hold a public hearing on the dental benefit program and had not investigated the cost, which she said was estimated at $11 million. Advocates for people on Medicaid said Ober not only overestimated the expense but failed to say that federal money would cover at least half of it. 

“To deeply misrepresent to the public one’s objections as Rep. Ober did with a specious argument is upsetting,” said Lisa Beaudoin, executive director of ABLE New Hampshire. “And on an issue that is fundamentally about health equity and people being able to lift themselves out of poverty and maintaining overall health is a deeply uninformed decision on her part.”

In an attempt to get Ober’s support, Sen. Jeb Bradley, a Wolfeboro Republican on the committee, offered to reword the legislation to make clear that state funding would be matched by federal funding.  

“We took a lot of testimony from physicians and dentists who talked about the correlation between good oral health and good overall physical health,” he said. “We would hope that the House (committee members) would see their way to supporting this as it makes a lot of sense from a public health standpoint.”

Ober declined but said the House looked forward to working with the Senate on it in the next legislative session. Lawmakers passed a bill in 2019 creating a working group to create a plan for the implementation of adult dental benefits. The $1.5 million the Senate included in the bill would have allowed the state Department of Health and Human Services to solicit contracts with a goal of providing dental coverage in 2023.

The federal government would not only cover half the cost of dental care for the 26,000 people covered by Medicaid, it would pay 90 percent of the cost for those on expanded Medicaid, which was estimated in 2019 to be 52,000.

The parents, advocates, and medical providers who testified during the budget hearing in May said Medicaid and expanded Medicaid recipients deserve both health and dental benefits, just as those covered by private insurance. Poor oral health is not only a health risk but also a barrier to getting a job, they said. 

“If you want adults with disabilities to be employed, and you want to keep down the cost for chronic health conditions, and you want people to recover from substance misuse disorder and go back to the work force to be employed so they can be tax-paying citizens, you need to provide dental benefits.”