The Idaho House has voted narrowly – 36-32 – in favor of HB 465, to restore non-emergency dental coverage to people who are on the Idaho Medicaid program’s basic plan; they lost that benefit through budget cuts in 2011 during the recession 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 Medicaid, largely very poor parents, many of whom have mental health issues. As a result, those patients are covered only for emergency extractions, and no other dental care. That’s led to increasing numbers of major infections and hospitalizations – for which Idaho’s Medicaid program is on the hook. You can read my full story here at spokesman.com.

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.” 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. She and other Health & Welfare Committee members said they heard stunning examples, 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 told the House.

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

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; it simply affects those already on the program.

The bill would affect just over 30,000 of the nearly 300,000 people who participate in Idaho's Medicaid program.

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 & 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.”

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,” including Colorado, which she said saw $10 million in annual savings once it restored non-emergency dental benefits, and Washington, which saw $12 million a year in savings; both states also had eliminated the benefit during the recession. “I think we owe it to our taxpayers to deliver those savings,” Rubel said.

Here’s how the vote broke down:

Voting yes: Reps. Amador, Anderson, Anderst, Bedke, Bell, Burtenshaw, Chew, Clow, Erpelding, Gannon, Gibbs, Hartgen, Horman, Jordan, Kauffman, King, Kloc(Tway), Loertscher, Malek, Manwaring, McCrostie, McDonald, Miller, Packer, Perry, Raybould, Redman, Rubel, Smith, Toone, Troy, VanOrden, Wagoner, Wintrow, Wood, and Youngblood.

Voting no: Reps. Armstrong, Barbieri, Blanksma, Boyle, Chaney, Cheatham, Collins, Crane, Dayley, DeMordaunt, Dixon, Ehardt, Gestrin, Giddings, Hanks, Harris, Holtzclaw, Kerby, Mendive, Monks, Moon, Moyle, Nate, Palmer, Scott, Shepherd, Stevenson, Syme, Thompson, VanderWoude, Zito and Zollinger.

The bill now moves to the Senate side.

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