Idaho House narrowly approves restoring non-emergency Medicaid dental benefits

A divided Idaho House narrowly passed legislation Monday to restore non-emergency dental coverage to more than 30,000 Idaho Medicaid recipients who’ve only had coverage for emergency extractions since 2011 – resulting in a jump in serious complications that have been costing the state’s Medicaid program far more.

Rep. Eric Redman, R-Athol, said, “It’s fiscally responsible to pass this bill.”

But the vote was close, with the measure squeaking through the House, 36-32.

The benefit was cut from all Idaho Medicaid patients during a round of recession-driven budget cuts in 2011, with the promise that they’d be restored when the economy improved.

“It was understood that this was likely to lead to serious downstream medical conditions,” Rep. Ilana Rubel, D-Boise, told the House; the move was supposed to be just temporary.

Two years later, the benefits were restored to children and people with major disabilities, but not to others on Idaho’s Medicaid program, largely very poor parents, many of whom have mental health issues.

Rep. Karey Hanks, R-St. Anthony, spoke out against the bill, saying, “This is another expansion of Medicaid. … I just see this as another Medicaid expansion creep, so I hope you will vote no.”

Rubel noted that no one would be added to Medicaid as a result of the bill.

Rep. Bryan Zollinger, R-Idaho Falls, said he lost a molar to an abscess when he was uninsured. “We’re not supposed to be spending other people’s money on items like this,” he said. “Currently less than half the population of Idaho has dental insurance. … We’re stealing money from the other half of the people. … While I have sympathy, it’s just not right.”

Rep. Fred Wood, R-Burley, a physician who chairs the House Health and Welfare Committee, said, “The disasters that can occur from poor dental hygiene are very significant – meningitis in children and the list goes on and on. It became apparent after two years that we really had made a mistake. … I do think that the savings will be real here, and I do think that the health of this population will be significantly improved by restoring these benefits.”

Though restoring the benefit would cost the state an estimated $1.24 million in state funds next year, it’s projected to save $2.5 million. Rubel and other Health and Welfare Committee members said they heard stunning examples during hearings on the bill, including one patient whose problem could have been solved with a $100 filling, but instead deteriorated into complications requiring extensive hospitalization and costing $70,000.

“We should get ahead of this, we should address these things when it’s $100 instead of $70,000,” Rubel said.

Rep. John VanderWoude, R-Nampa, said he wasn’t convinced that there would be any savings, because Medicaid costs overall continue to rise. “We continue to spend money without seeing any savings anywhere,” he said.

Rubel said Idaho’s Medicaid costs, while increasing, have been going up at a rate that’s lower than inflation, though the state’s population is increasing. “But one of the reasons it’s going up, I would put to you, is because we’re not doing things like this,” she said. “Other states that have done this have found very real savings.”

Rep. Kelley Packer, R-McCammon, a co-sponsor of the bipartisan bill, said, “We now, as a society and as taxpayers, have to pick up those ICU visits and those emergency room visits at astronomical cost to each of us.”

To become law, the bill still needs to clear a Senate committee, pass the Senate, and receive the governor’s signature.