Dental Health

Daniel Harris, age 4, is just one of 600,000. But he’s an important one, and not only to his mom. Daniel is one of the first kids in California to have lost insurance coverage for certain health care services as a result of the state’s transition from Healthy Families to Medi-Cal managed care.

The lack of timely and appropriate access to dental care for low-income children and adults is one of the most overlooked problems of California’s health care system. It can also be life-threatening when not addressed.

The challenges facing California policymakers will become more substantial as the state embarks on a massive expansion of Medi-Cal, the state’s public insurance program for the poor.

California is readying itself to significantly expand its Medi-Cal dental program starting next year as part of President Barack Obama’s signature health care law and the state’s ambitious plan to transition more than 875,000 children out of the Healthy Families program into Medi-Cal.

By this time next year, about half of California’s children – roughly five million — will get dental care through Medi-Cal, California’s Medicaid program.

Or maybe they won’t.

A new issue brief from The Children’s Partnership suggests California’s Medicaid system may not be up to the task.

Tooth decay is the most common chronic health problem in children. By the time they enter kindergarten, more than a quarter of kids have decay in their baby teeth. The problem worsens with age, and nearly 68 percent of people age 16 to 19 have decay in their permanent teeth, according to the Centers for Disease Control and Prevention.

Starting in 2014, the Affordable Care Act requires that individual and small-group health plans sold both on the state-based health insurance exchanges and outside them on the private market cover pediatric dental services. However, plans that have grandfathered status under the law are not required to offer this coverage.

At Maplewood Community Dental Care outside of Minneapolis, dental therapist Megan Meyer regularly fills cavities, extracts primary teeth and puts in crowns and spacers. In most dental practices around the USA, such procedures are the sole responsibility of a dentist. But that’s not the case at this community clinic and at a handful of others in Minnesota, where a new type of dental-care practitioner handles these and other basic preventive and restorative services under the supervision of a dentist on-site.

SANTA CRUZ – A $1.4 million grant will help Dientes Community Dental Care add a new pediatric wing to its Mid-County location, expanding the availability of dental care for the county’s poor.

The award was by far the largest of three the county received last week, when state officials announced more than $51 million in funding statewide. But the county did get all it sought, losing out on hundreds of thousands worth of grant requests aimed at helping the poor.

Hundreds of hopeful and needy people received free dental services at Cal Expo on Friday [August 24, 2012] in what’s become a dubious tradition in this do-without economy: another big-tent, M*A*S*H-style health care bonanza, this time exclusively for oral care.

Inside Cal Expo’s cavernous buildings C and D, the California Dental Association assembled a cadre of volunteer dentists and their crews for what’s called CDA Cares, a two-day free clinic that concludes today. Organizers said they hoped to serve 1,500 to 2,000 people by closing time, having seen 1,000 people Friday.

Cash-strapped California is aggressively moving its poorest residents to managed health care, whether they’re seniors, rural residents or people with disabilities.

So, when Gov. Jerry Brown proposed earlier this year to transfer the nearly 900,000 poor children in the Healthy Families insurance program into Medi-Cal, he saw it as another opportunity to reduce costs by expanding dental managed care.

But something happened between then and now, and that something was Sacramento County.

Sacramento County’s poorly performing Medi-Cal dental managed care program foiled Brown’s plans, legislators say.