June 03, 2020
By David Burger
Denver – Early on May 20, the state Medicaid program had announced that Colorado state adult dental Medicaid benefits would be cut from the state budget.
The Colorado Dental Association was ready and kicked into action, and by the end of that day, the state Medicaid program, Health First Colorado, had reversed its decision and announced that existing adult dental Medicaid benefits were restored and safeguarded.
“It was like my birthday,” said Dr. Jeff Kahl, president of the Colorado Dental Association, vice chair of the ADA Council on Membership and a long-time advocate for the adult dental Medicaid benefits program.
“Jeff and I had worked on getting an adult Medicaid benefit in Colorado for well over a decade and were devastated when they were planning on getting rid of it,” said Dr. Kahl’s wife, Dr. Carol Morrow, former president of the association and chair of the ADA Council on Advocacy for Access and Prevention’s Access & Advocacy Subcommittee. “We are super excited they have decided to keep it.”
Colorado Gov. Jared Polis and his state were facing a massive budget shortfall resulting from steep declines in sales and income taxes because of the coronavirus, so in May he and the state general assembly were considering hundreds of millions of dollars in cuts that would affect health insurance for children, comprehensive care for adults with disabilities, substance abuse treatment, education in youth detention centers and the state’s adult dental Medicaid program.
In 2013, the state legislature passed Senate Bill 242, which authorized the state to create a new limited dental benefit in Medicaid for adults age 21 and over. The new dental benefit provided Medicaid members up to $1,000 in dental services per state fiscal year, and in 2019, the budget bumped up the annual dental benefit maximum for adults from $1,000 to $1,500.
“This is a whole population who never had any treatment,” said Dr. Kahl. “It has changed their lives.”
Dr. Kahl said he and the association’s government relations committee knew early on that the adult dental Medicaid program might be on the chopping block, as the governor announced he would be slashing spending from the proposed budget.
“We felt that the lowest hanging fruit might be the adult Medicaid dental benefit,” Dr. Kahl said. “And there were a couple individuals who were trying to make cuts with an ax rather than a scalpel.”
However, Drs. Kahl and Morrow and other CDA members decided against a plan in which they would make impassioned pleas to the state that the dental benefit plan was more worthy than other programs for the disadvantaged. They instead offered a measured, proactive approach that took what they called the middle road.
“We weren’t begging for money,” Dr. Kahl said. “We were trying to be part of the solution.”
The CDA talked to legislators and acknowledged that they knew the lawmakers were under enormous pressure. The association said they expected cuts, but wanted to make sure the entire dental program wasn’t decimated, Dr. Kahl said. Once gone, they reasoned, the program that they worked so hard to enact in the first place would be hard to bring back.
One of the final legislators Dr. Kahl and other CDC members met with was the influential state Sen. Dominick Moreno, chair of the state senate joint budget committee. Dr. Kahl said Sen. Moreno listened to their proposal intently, and shortly thereafter, made the decision to recommend that the adult dental Medicaid program be saved.
The final recommendation that the committee presented wasn’t without cuts, but the program was saved. One of the provisions reduced the $1,500 cap to $1,000. In addition, there was a $1 million reduction to the Senior Dental Program and a 1% cut in the amount of money Medicaid providers would be reimbursed for each procedure.
“That is nothing compared to an elimination of the Senior Dental Program and adult benefit and a 15-20% rate cut that was on the table,” Dr. Morrow said.
Drs. Kahl and Morrow are cautiously optimistic, as the state budget hasn’t been finalized and passed yet.
“We’re still keeping our eye on the ball,” Dr. Kahl said.
But the program was worth fighting for, they said.
“We want to make sure this is a meaningful benefit,” Dr. Kahl said. “Everyone needs to be taken care of.”