Approximately 37 million kids—more than a quarter of the children in the United States—are enrolled in Medicaid and the Children’s Health Insurance Program (CHIP). Although dental health is covered state data shows that only about one-third of Medicaid-enrolled children receive any dental care in the course of a year.
Many dentists don't accept Medicaid, primarily due to low reimbursement rates and administrative hassles. Most states report that each year fewer than 25 percent of dentists see even 100 Medicaid patients. As a result, families face difficulty locating care, long waits and much frustration. In rural areas, these obstacles are compounded by long travel distances.
The current system can do more to reach children where they live. Medicaid and CHIP should be reshaped to empower families and expand the delivery of dental services to places that are more accessible to children in need. Patient navigators, care coordinators, case managers and disease management programs can also help families achieve dental health.
Pew's effort to improve children's dental policy is partnering with dental provider associations, consumer groups and children’s advocates at the state and federal levels to increase federal support for Medicaid and CHIP and ensure federal requirements make it easier for states to operate successful dental programs.
Because many children will see doctors and nurses earlier and more often than dentists, states have turned to medical providers to help prevent tooth decay. Medicaid programs in more than 30 states currently reimburse medical providers for preventive dental health services for children, including the application of fluoride varnish, a concentrated form of fluoride that is applied to children’s teeth to prevent cavities. Pew's effort to improve children's dental policy is partnering with pediatricians to expand the number of states that provide Medicaid reimbursement to medical practitioners.