A Healthy Blog

Massachusetts health care — wonky, with a healthy dose of reality

House Approves MassHealth Dental Fillings in Budget; Still Cuts MassHealth

House Approves MassHealth Dental Fillings in Budget; Still Cuts MassHealth

April 29, 2013

It was hard to notice. But an obscure section in a the final, technical amendment during the House budget debate would allow over 800,000 low-income adults to receive dental fillings under the budget approved by the Massachusetts House of Representatives Wednesday night. The budget amendment added $17.2 million to restore coverage for fillings in the MassHealth adult dental plan, effective January 1, 2014. Those benefiting include 120,000 seniors and 180,000 people with disabilities.

Oral health is a crucial part of overall health. Left untreated, dental decay can spread throughout the body, causing serious and permanent health issues. Over 800,000 Massachusetts residents are impacted by the 2010 cuts to the MassHealth adult dental program. Some of the most vulnerable residents of our Commonwealth have faced daunting challenges in attempting to access oral health care in the wake of the cuts to MassHealth adult dental benefits.

The current program provides very limited services such as cleanings, screenings, extractions, and very limited fillings, for front teeth only. Access to complete fillings means that infections can be stopped before they become a systemic health issue, before teeth have to be pulled, and before individuals are forced to show up in the emergency room because of significant mouth pain.

The full restoration of MassHealth adult dental benefits is among HCFA's top priorities. We applaud House Ways & Means Chairman Brian Dempsey and House Legislative Oral Health Caucus Chair Representative John Scibak for their leadership.

The House did not include additional funds requested for administrative support for the MassHealth program. Without these funds, delays in MassHealth enrollment and member processing will continue to worsen.

Our friends at Mass Budget and Policy Center have a full report on the House final budget. For MassHealth, there are still major cuts coming if the House version prevails:

... [F]unding for MassHealth in the final House budget remains about $208.0 million below the amount proposed by the Governor. A portion of that overall gap can be explained by the following differences between the two budgets:

  • The House does not fully restore dental coverage ....
  • The House eliminates $11.7 million in funding, proposed in the Governor's H1 budget, that would allow MassHealth to maintain coverage for about 3,400 legal immigrants who will not be eligible for coverage under the ACA, and to extend MassHealth coverage to about 900 disabled adults by extending new ACA rules for calculating income eligibility to cover people with disabilities.
  • It appears that the House does not follow the Governor in allocating $10.0 million for primary care provider rate increases.
  • The House budget proposes to tap an off-budget trust fund (the Healthcare Payment Reform Trust Fund) to pay for some costs that were included in H1 line items. ...

After taking these differences into account, there is still a sizable gap—more than $100 million— between the funding levels proposed by the Governor and the House. While some of this difference may result from different assumptions about enrollment growth, the state's ability to control health cost growth, and the state's ability to employ cash management strategies that shift costs into subsequent years, administration budget writers indicate that it will be difficult — if not impossible — for MassHealth to implement this lower level of spending without affecting either rates for providers or services for low-income patients.

We have already begun working with the Senate to restore the full range of MassHealth adult dental benefits, along with other priorities, when they take up their budget proposal in May.
-Cortney Chelo and Brian Rosman