HARTFORD, Conn. (AP) - Connecticut dentists say eight years of efforts to expand access to dental care for needy children could be put at risk if state legislators agree with Gov. Dannel P. Malloy's proposal to scale back the state's Medicaid reimbursement rate for dentistry services.
The Democratic governor included a 10 percent cut in the reimbursement for children's dental services provided under the state's HUSKY health insurance program in the revised, $19.7 billion budget plan he released on Tuesday to help cover a projected $922 million deficit. The Connecticut State Dental Association, which represents 2,200, or 64 percent of the state's dentists, contends any reduction will discourage dentists from serving poor residents.
"Dentists cannot afford to receive less reimbursement for Medicaid services," said Dr. William Nash, the association's president, adding how inflation has already eroded the reimbursement rate in recent years. "Cutting reimbursement rates will cause dentists to drop out of the HUSKY program."
Malloy's proposed reduction is projected to save the state $5.3 million in the new fiscal year beginning July 1. It's unclear whether it will ultimately be part of a budget agreement that can pass the General Assembly. Democratic legislative leaders have said they doubt Malloy's unusual, mid-legislative session revised budget could clear the legislature given various unpopular cuts.
Last year, lawmakers ultimately scrapped a similar proposal to cut the reimbursement rate by 6 percent.
David Dearborn, spokesman for the Connecticut Department of Social Services, questioned the dentists' claims that a 10 percent reimbursement reduction will affect patient access to dental services. He said Connecticut is a national leader in public coverage of dental services through the Medicaid/HUSKY program.
"When surveyed in 2015, nearly all of our provider reimbursement rate schedule for children was significantly higher than other New England states, New York and Pennsylvania," he said. "We don't believe this rate adjustment would affect continued access by children to excellent care by the many dedicated practitioners enrolled in the program."
But Nash said the state could take other steps to cut costs in the program, such as impose a benefits cap. He said private plans often limit coverage to about $1,500 a year, while there's no annual limit under the HUSKY program.
Poor families in Connecticut experienced a difficult time for years accessing dental health services, partly because of the low reimbursement rate, according to advocates. But a 2008 lawsuit settlement agreement helped to improve those rates, moving them closer to those of private insurance companies, and ultimately encouraged more dentists in private practices to participate and offer their services.
A December 2015 report from the American Dental Association's Health Policy Institute found 64 percent of Medicaid-enrolled children in Connecticut visited a dentist in 2013. That's compared to 32 percent of Medicaid-enrolled children in 2005.
Nash said there has been an increase in preventative care under HUSKY while there's been a decrease in restorative care, such as fillings and crowns.
"This means that we are able to help prevent suffering and more costly dental repairs," he said.
Malloy, whose administration is in the process of laying off hundreds of state employees to help address the deficit, has said unpopular cuts are necessary given the state's continued revenue challenges.
"Our expectations need to change," he said. "We cannot afford to fund everything we always have."