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« VICTORY! State Legislature to Restore Adult Dental Medicaid »


After six months, the 2013 legislative session—a combination of a 105-day regular session and two special sessions—has come to a close. The House and Senate came to a compromise and passed a 2013-15 Biennium Operating Budget only two days before state government would have been forced to shut down. The final $33.6 billion budget includes $1 billion in new court mandated K-12 education funding, a 12 percent funding increase for higher education, and very little revenue generated from new taxes.

The 2013-15 Biennium Budget passed by the legislature includes funding for a comprehensive dental benefit for all Medicaid-eligible adults. Adult dental Medicaid funding will be restored on January 1, 2014. Most Medicaid-eligible adults currently only have access to emergent care.  For three years, Medicaid has only provided 38,000 of the states nearly 500,000 Medicaid-eligible adults with a comprehensive dental benefit.

Funding for adult dental Medicaid was included in the budgets developed by the Governor, House, and Senate, though at different levels. Initially, the Governor’s and the House’s budgets provided funding to fully restore the dental Medicaid budget to pre-2011 levels while the Senate’s budget partially restored dental funding for preventive care and dentures. The compromise budget passed in late June fully restored the dental benefit.

The legislature also decided to expand Medicaid eligibility to more low income adults. Under the Affordable Care Act, states have the option to expand Medicaid eligibility to all adults who earn less than 138 percent of the federal poverty level. Initially, the federal government will pay 100 percent of the cost of Medicaid benefits for this expansion population. The federal match eventually drops to a 90 percent match in a few years. Restoring a comprehensive dental benefit for the existing Medicaid-eligible adults allows the state to also provide a comprehensive dental benefit for adults who are newly eligible for Medicaid under Medicaid expansion.

Restoration of adult dental Medicaid funding will also have a very positive impact on the state’s community health centers, dental residency programs, and the University of Washington School of Dentistry. Medicaid funding is a significant source of revenue which allows these programs to provide dental access to many of the state’s most vulnerable populations. Currently, dental treatment provided by these programs to Medicaid-eligible adults is done without compensation or on a sliding fee schedule based on a patient’s ability to pay.

Reinstating adult dental Medicaid funding is the result of persistent advocacy from legislators from both parties and several advocacy organizations. Special recognition must be directed towards the lobbyists and organizations in the Coalition to Fund Dental Access. This coalition was co-created in 2007 by the WSDA and now includes University of Washington School of Dentistry, Solid Ground, Washington Association of Community & Migrant Health Centers, Poverty Action Network, Washington Dental Service Foundation, Children's Alliance, Washington State Dental Hygienists Association, and many other organizations.

Reader Comments (6)


07.4.2013 | Unregistered Commentercleanelection

The problem is DSHS is not very good at conveying information about dental benefits to Medicaid recipients!!! When you are eligible for Medicaid, you don't even receive ANY information on how the health benefits work. I ended up looking everything up on the internet. When it comes to dental benefits, there is NO information even available on the internet. So as an adult Medicaid recipient, I don't know what dental procedureas are covered. Nothing is sent to you in the mail. It's all a guessing game. Other states are much more proactive about administering their programs. I think the doctors/dentists are not the only ones who need to know what EXACTLY is covered. The patient should know as well before seeking out treatment. It's common sense.

I was in an accident in 2007 and some of my molars and wisdom teeth got broke but now one by one my teeth are breaking exposing the nerve and I have been trying to find a dentist who accepts Medicaid so I can have my teeth pulled and have dentures so it stops I have read that it can cause heart disease and stroke and I am a 25 year old mother of 3, I am more into doing this for my kids so I will be here for them as they grow I would like to know what benefits are available to me since I can not afford insurance and cant work I have Medicaid and badly need my teeth pulled. please offer detailed information

01.22.2014 | Unregistered Commenterashley johnson

I've always had issues with finding providers. The best thing to do is call medicaid and ask them what is covered.

It appears that the Dentists, that are part of the Medicaid Dental program, have no idea what is covered by the new law. They try to call but are on hold with the medicaid office for hours. This is causing a lot of problems. I'm trying to help an unemployed friend, who has his medicaid card and no income, get dentures. One problem after another. Inevitably they pass him information on how to finance the new dentures. They really need to notify all the Dental labs and let them know what is going on...what is covered under the plan, who is eligible with what information is on the card etc...... The dentist should not have to tie up their phones for hours to get an answer. This information needs to be upfront to the dentists and available, so the patients can move forward and get the care they need.

03.10.2014 | Unregistered CommenterRicky Kendall

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