Posted: January 15, 2013
Children's health advocates are cheering provisions in the health care law that will increase dental coverage for children. But with dentists scarce in some parts of the country and others not taking Medicaid patients, parents may find it hard to get the care their kids need.
Kids may not exactly jump for joy to learn that the health care overhaul makes it easier for them to get their teeth cleaned, filled and straightened.
Tooth decay ranks as the No. 1 chronic disease in children, and better dental insurance coverage could help address the problem. But many children's health advocates worry that there won't be enough dentists available to meet the need.
Some children will gain access through the requirement that individual and small group health plans sold on the state-based health insurance exchanges and on the private market offer pediatric dental coverage.
Pediatric dental coverage is already required under Medicaid, but many children aren't enrolled and even if they are, often they don't receive services.
The health care law may give more children access to dental coverage through the program as it expands coverage in many states to adults with incomes up to 133 percent of the federal poverty level. Advocates expect that as more parents enroll in the program, more children will gain dental coverage.
But dental coverage is helpful only if there are providers available who are willing to see those children.
"Many dentists aren't comfortable seeing young children," says Colin Reusch, a senior policy analyst at the Children's Dental Health Project who co-authored a recent study on the law's pediatric dental coverage. "They're not cooperative in the dental chair."
Families of children who are covered under Medicaid often encounter additional problems. They run into language or transportation barriers, or can't find a dentist who accepts Medicaid patients.
A 2010 report by the Government Accountability Office found that fewer than half of the dentists in 25 out of 39 states treated any Medicaid patients in the previous year.
In addition, some areas, including rural communities, just don't have enough dentists. "We have huge and well-documented access problems in this country, with 45 to 50 million people living in dental shortage areas," says Shelly Gehshan, director of the Pew Children's Dental Campaign.
Dentists, though, say there's no shortage of practitioners. "We think the number of providers is more than acceptable," says Robert Faiella, president of the American Dental Association. According to research, he says, 73 percent of dentists have the capacity to accept more patients.
But distribution can be a problem, he concedes. "We're trying to find ways to work with community health centers and local dentists to provide that safety net to meet that need more equitably," he says.
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