One of the most significant bills passed during the 2020 legislative session is expected to go into effect on January 1, 2021. SB 648 adds a dental benefit to the state’s adult Medicaid program, extending this important coverage to an estimated 310,733 West Virginia adults. The legislation provides for each adult Medicaid recipient to be eligible for up to $1,000 in dental care each calendar year, including preventive, diagnostic, and restorative services such as the provision of dentures, dental implants, bridges, and crowns, and corrective procedures like root canals.
Prior to the legislation, West Virginia was an outlier, offering only emergency extractions to adult Medicaid enrollees, with 36 states offering more extensive dental benefits to this population. This left many adults with no choice but to wait until a tooth was at the point of needing to be pulled to receive dental care. In addition to overall oral health, many chronic health conditions are impacted by untreated oral conditions, including atherosclerotic disease, osteoporosis, kidney disease, and pregnancy complications. Poor oral health, including loss of teeth, also impacts employability and absenteeism, worsening residents’ financial stability and our state’s economy.
Over the long-run, the state’s costs of providing dental services will likely be offset by savings from improved health outcomes, reduced use of emergency department services for dental conditions, and reduced Medicaid expenditures on the related chronic conditions impacted by oral health.
For adults who rely on Medicaid, this benefit could be life-changing — impacting mental well-being, employability, and overall health. It is a great investment in West Virginia’s residents and a significant achievement for our state legislature.
Below is a breakdown of the estimated number of adults per county who will gain access to dental benefits when the legislation goes into effect on January 1.
Methodology: We obtained the most recent Medicaid enrollment figures from the Centers for Medicare and Medicaid Services (CMS). This provides monthly Medicaid enrollment by state, including total Medicaid and Children’s Health Insurance Program (CHIP) enrollment and total Medicaid and CHIP child enrollment. The latest data available was from July 2020. We calculated the total number of adults on Medicaid in West Virginia by subtracting the child Medicaid and CHIP enrollment from the total Medicaid and CHIP enrollment.
Utilizing Department of Health and Human Resources’ county-level enrollment data, we calculated the county’s share of total Medicaid enrollment, and then applied that percentage to the total number of adults on Medicaid from the CMS report in order to estimate the number of adults in each county who will become eligible for dental benefits when SB 648 goes into effect on January 1, 2021.
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