Two years ago, the Illinois State Dental Society (ISDS) was instrumental in persuading members of the Illinois General Assembly and then Gov. Pat Quinn to pass a budget that included funding for dental coverage for adults through Medicaid.
The approval restored adult dental benefits within Medicaid two years after eliminating coverage.
Dr. Sameera Hussain, president of Dental Dreams, told Illinois Business Daily that extending coverage to adults benefits not only an untold number of Illinoisans but the state as well.
“I give Illinois and other states that have recently extended Medicaid coverage to adults (in addition to children) a great deal of credit for not only addressing an essential health need for everyone regardless of age or income level but for also enacting policy that is financially sound,” Hussain said.
Under federal law, state Medicaid programs are required to include dental care for children, and the Affordable Care Act (ACA) extended that requirement to private insurers. However, federal health law did little for adults because ACA subsidies cannot be used to purchase dental coverage except as an add-on to health coverage, and dental benefit requirements were not included for adults under Medicaid, Hussain said.
“When adults don’t have dental coverage they oftentimes don’t take their children (who are covered) for dental care either,” Hussain said. “The result was that dental needs went unmet and forced people to go to emergency rooms for their dental problems, which is much more costly than the routine, preventive dental care provided in our offices and now covered for all individuals enrolled in Medicaid.”
Hussain, whose dental practice is comprised of more than 250 dentists in 65 Dental Dreams offices across 11 states, said that people who go to emergency rooms for dental problems often lose teeth that could have been saved with regular dental visits, and the cost of treating a patient in an emergency room rather than in a dental office is 60-70 percent greater for the state of Illinois.
“I am very pleased that Illinois’ leaders recognized their past mistakes and did what was necessary to restore essential medical services to low income residents," Hussain said. "This is one of those rare instances where providing additional medical benefits actually saves taxpayer dollars.”
The extended coverage has caused longer delays for patients signing up for appointments because only a limited number of dentists in the state accept Medicaid patients.
“In Illinois and throughout the country there is an extreme shortage of dentists providing care to Medicaid patients," Hussain said. "Only an estimated 800 dentists in Illinois accept Medicaid patients. And out of that number, only a very small percentage of that group dedicate a significant portion of their practice to Medicaid patients in the way that we do at Dental Dreams.”
Hussain launched Dental Dreams in 2001 in Aurora, Illinois, in response to a deep desire to provide dental services to individuals in underserved communities.
From a business standpoint, Hussain said the downside to accepting patients with state-provided coverage is that reimbursement rates are low for treatment of Medicaid patients, and states can be slow in paying their bills, which makes it challenging to manage the finances of providing care to low income and economically challenged communities.
“The health care system can provide perverse incentives at times,” Hussain said. “A dental practice oftentimes receives better reimbursement rates for treating patients with private insurance than Medicaid. So the patients with the least economic means are left with very few dentists willing to treat them and don’t have the financial ability to pay out of pocket for dental care.”
Hussain said the reason she has dedicated her career to treating Medicaid patients and to locating her dental offices in areas with the largest percentage of Medicaid enrollees is because that is where the greatest need in dental care is.
“In Illinois we recently opened a new office in the Chatham neighborhood on Chicago’s South Side and expanded the services provided in our Machesney Park office near Rockford," Hussain said. "In addition, we’ve added more dentists and support staff to our 18 Illinois offices to meet the needs of our patients,” she said.
Hussain emphasized the importance of dental health as an important component of overall well-being.
“By seeking preventive care before a problem arises, a patient can avoid unnecessary pain, preserve their teeth and benefit their health in general,” Hussain said.
Dental Dreams assists patients by educating them about the availability of comprehensive dental coverage for all Medicaid beneficiaries.
“We are proud to be playing a small part in ensuring all Illinois residents have access to high quality dental care and would like to thank our associates for their role in aiding those in need of care,” Hussain said.