Bill Text: HI SB2459 | 2020 | Regular Session | Introduced
Bill Title: Relating To Medicaid Benefits.
Spectrum: Partisan Bill (Democrat 11-0)
Status: (Engrossed - Dead) 2020-03-09 - Referred to HSH/HLT, FIN, referral sheet 36 [SB2459 Detail]
Download: Hawaii-2020-SB2459-Introduced.html
|
THE SENATE |
S.B. NO. |
2459 |
|
THIRTIETH LEGISLATURE, 2020 |
|
|
|
STATE OF HAWAII |
|
|
|
|
|
|
|
|
||
|
|
||
A BILL FOR AN ACT
RELATING to MEDICAID benefits.
BE IT
ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
SECTION 1. The legislature finds that oral disease is a significant health problem among many Hawaii residents, affecting their overall health and well-being. Since 2010, Hawaii has received a failing grade of "F" in three oral health report cards published by the Pew Center of the States due to multiple policy and systems issues in the State that has left the oral health of Hawaii's families and children in a state that is worse than the rest of the nation.
Access to regular oral healthcare varies greatly across the State, with rural and neighbor island residents and persons with low-income families experiencing greater access issues. Currently, approximately 180,000 adult medicaid beneficiaries are not getting the benefit of early oral disease detection and treatment for better overall health. Lack of access to dental coverage and oral healthcare is a health and social justice issue that disproportionately affects the poor, children, the elderly, and racial and ethnic minority groups.
In 2009, the State of Hawaii terminated all
preventative and restorative dental care services for adult medicaid recipients
and replaced it with emergency room services that are limited to pain relief,
injuries, trauma, and tooth removal and extraction. Nationally, studies have shown that reducing
or eliminating medicaid adult dental benefits has led to significant increases
in dental-related emergency room visits and associated costs. In 2012 alone, Hawaii medicaid paid $4,800,000
for 1,691 adults for emergency room visits for preventable oral health
problems, according to the department of health's Hawaii Oral Health: Key
Findings report.
In Hawaii, a disproportionate number of adult
medicaid beneficiaries ages twenty-one and older utilize emergency dental services.
While they are twenty-five per cent of Hawaii's population, they represent fifty-six
per cent of all emergency dental services. Just over 3,000 emergency room visits for
acute oral health conditions occurred in 2016, totaling over $17,000,000 in
direct costs, a cost that has more than doubled since 2007. Data also indicated that rural
residents of the State, primarily from the north shore of Oahu and the islands
of Kauai and Hawaii, were more likely than urban residents to go to the
emergency room for dental problems.
The lack of preventative and restorative
dentistry services for adult medicaid beneficiaries increases potential health care
complications and costs for individuals living with diabetes, including an
increased incidence of gum disease, increased difficulty controlling diabetes
and an increased likelihood of coronary artery disease. These complications can all lead to increased
disability and death. For diabetic medicaid
beneficiaries, increased access to dental care could result in a cost savings between
$118,000 and $1,700,000 for diabetic medical care for all beneficiaries, according
to 2019 estimates by the Healthy Policy Institute of the American Dental
Association.
For pregnant adult medicaid beneficiaries,
ensuring good oral health during pregnancy may reduce pregnancy complications such
as pre-eclampsia, giving birth too soon, or having low birth-weight babies. The average cost of services for the birth of
a healthy newborn is approximately $5,000. In contrast, the cost of services for a premature
or underweight newborn can range from $200,000 to $2,000,000.
Poor oral health is clinically proven to have
serious adverse impact on overall health and well-being. It is linked to an array of acute and chronic
health conditions including heart disease, diabetes, stroke, depression, low
birth weight, and premature birth among others.
Tooth decay is almost completely preventable. However, preventive services, early
diagnosis, and interventions that can halt or slow the progression of most oral
diseases is currently unavailable to adult medicaid beneficiaries in the State.
Problems that could have been addressed
early, or even prevented, continue to progress, leading to poor health outcomes
and lower quality of life.
Dental care coverage is positively
associated with access to and utilization of oral healthcare. Research indicates that children and adults
with dental coverage are significantly more likely to seek and use regular
dental services than those who are uninsured.
Individuals enrolled in medicaid have an
increased likelihood of disparities in health care outcomes based on income. The prevalence of dental disease and tooth
loss is disproportionately high among low-income populations. Insufficient coverage or access to care often
further disadvantages medicaid recipients, driving poor health outcomes and
higher costs.
Expanded adult dental benefits can have
tremendous positive impacts on state medicaid populations. It has been shown that individuals with
dental benefits are forty-two per cent more likely to have a dental checkup
within the year than individuals who do not have coverage. Parents who receive dental care are also more
likely to take their children to the dentist as well.
Medicaid provides federal funds for health care
coverage to eligible individuals with low incomes, including children and their
parents, pregnant women, the elderly, and persons with disabilities. The federal government will match up to fifty
per cent of a state's investment in reinstating preventative and restorative
dental benefits for adult medicaid beneficiaries.
Although comprehensive dental coverage is
mandatory for children enrolled in medicaid, dental benefits for medicaid-eligible
adults are optional. Currently,
thirty-four states offer comprehensive or limited preventive and restorative
benefits to adults on medicaid.
Adding expanded dental services
benefits for the State's adult medicaid enrollees will reduce the number of
acute oral health-related emergency room visits and improve these individuals'
chronic disease risks and overall health status. Current estimates on costs of restoring
expanded benefits to adult medicaid recipients in Hawaii that will provide a
range of preventive and restorative benefits for recipients to help maintain
and improve their oral health are being developed by the department of human services
MedQuest division.
It has been over a decade since the State
removed all but emergency medicaid adult dental benefits. The legislature finds that it is in the best
interest of the State and its residents to expand access to care by restoring
dental benefits to adult medicaid enrollees.
Accordingly, the purpose of this Act is to appropriate funds to restore
diagnostic, preventive, and restorative dental benefits to adult medicaid enrollees.
SECTION 2.
There is appropriated out of the general revenues of the State of Hawaii
the sum of $7,000,000 or so much thereof as may be necessary for fiscal year
2020-2021 to restore diagnostic, preventive, and restorative dental benefits to
adult medicaid enrollees; provided that the department of human services shall
obtain the maximum federal matching funds available for this expenditure.
The sums appropriated shall be expended by the department of human services
for the purposes of this Act.
SECTION 3. This Act shall take effect on July 1, 2020.
|
INTRODUCED BY: |
_____________________________ |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Report Title:
Adult Dental Benefits; Medicaid; Appropriation
Description:
Makes an appropriation to restore certain adult dental benefits to medicaid enrollees. Requires maximization of federal matching funds.
The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.
