3-minute read

Join our guest blogger, Devin McBrayer, as she explores the role of Medicaid expansion in the midterm elections and the potential impact on low-income adults’ access to dental benefits. Devin is a legislative and policy analyst based in Sacramento, California.

Midterm elections are just around the corner on November 6, and the results of the election could change the future of Medicaid in several states. Medicaid expansion is an important platform issue for some contested governors’ races as well as the subject of several ballot initiatives across the country. If more states expand Medicaid coverage for adults through the Affordable Care Act (ACA), dental coverage for low-income adults could also grow.

Currently, 33 states, plus Washington D.C., have opted to expand Medicaid, and 14 states have chosen not to do so. Three states, Idaho, Nebraska and Utah, will vote on Medicaid expansion for the first time this Election Day. If these states vote to expand their Medicaid programs, an additional 300,000 low-income Americans would be eligible for coverage. Montana also has a ballot initiative to extend their temporary expansion that covers 100,000 people in the state. Unless Montana voters approve the ballot initiative, the temporary expansion of Medicaid will end in 2019.

Several hotly-contested races for governor also feature Medicaid expansion as a central issue for candidates. Florida, Georgia, Kansas and Wisconsin all have Democratic gubernatorial candidates interested in expanding Medicaid if elected. Medicaid expansion could open the doors to providing more extensive dental benefits for those states’ adult populations in the future. Florida and Georgia’s current state Medicaid programs, in particular, offer emergency-only adult dental benefits, which are most often limited to pain relief under very specific situations.

Most states offer a limited dental benefit to their adult Medicaid population, but since adult dental is not a required benefit and the state must pay the entire cost of providing the benefit, fewer than half of states offer an extensive adult dental benefit. In FY 2018, 19 Medicaid expansion states chose to enhance the covered benefits in their Medicaid program, and three of those states, Arizona, California and Utah, chose specifically to enhance the dental benefit or access to dental services.

Along with the impact of elections on Medicaid expansion, it’s important to have an eye on the economic conditions. States that expanded their Medicaid programs in 2014-2016 received a 100% funding match from the federal government for newly eligible Medicaid enrollees. However, this federal match has begun to phase down and by 2020 the match will drop to 90%, which will force states to finance a greater share of the costs of Medicaid expansion. Delta Dental will continue to monitor these important elections and other trends that could have big impacts on low-income adults’ access to dental benefits across the country.

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