Arizona’s Disabled Adults Gain Financial Relief Through Vital Dental Benefits

Arizona has begun to alleviate the financial burden of dental care for families who care for disabled adults. Robert Houston, a retired law enforcement officer, was grappling with high costs for dental care for his 29-year-old daughter Whitney, who has a rare chromosomal disorder. After her mother passed away when Whitney was just five years old, Robert took on the responsibility of her care alone. Until recently, Arizona’s Medicaid program did not cover dental expenses for disabled adults like Whitney.

The restoration of dental benefits for disabled Arizonans over the age of 21 marks a significant change. Since October 1, those enrolled in the Arizona Long Term Care System (ALTCS) can access $1,000 annually for dental services. This benefit was reinstated by the legislature during the 2016 budget process, reversing a policy change made in 2006 that eliminated such coverage.

Critics, however, emphasize that this benefit is just a small step in addressing broader oral health needs. Many families have felt the strain of unexpected dental costs once their children reached adulthood, particularly for those with disabilities who often experience additional challenges. Individuals with disabilities typically struggle with basic oral hygiene and may require sedation for dental procedures, which can complicate their care.

Despite this progress, the overall dental coverage for adults under Arizona’s Medicaid program remains inadequate, according to Kevin Earle, executive director of the Arizona Dental Association. Emergency dental situations frequently arise, leaving many without the necessary care. Earle observed that patients often resort to emergency rooms when they have no dental insurance, a situation that is both costly and disheartening.

Arizona stands apart as one of only four states without any dental benefits for non-disabled adults on Medicaid. The others are Alabama, Tennessee, and Delaware. However, Governor Doug Ducey’s proposed budget for the fiscal year 2018 allocates $1.5 million aimed at providing emergency dental services to around 850,000 adults enrolled in the general Medicaid program. This proposal comes after the state removed emergency dental coverage in 2010 due to budget concerns.

Interesting studies highlight the increasing dental health risks for pregnant women on Medicaid, aggravating the existing gaps in coverage. State Rep. Kelli Butler proposed a bill for pregnant women to receive up to $1,000 annually for dental benefits, similar to the ALTCS benefit. While the bill received unanimous support in committee, it failed to advance for a vote. Advocates argue that maintaining good oral health during pregnancy is crucial for positive birth outcomes.

The recent dental benefit for disabled adults, while valuable, could be expanded. Tucson pediatric dentist Dr. Michael LaCorte noted that individuals with developmental disabilities might require anesthesia more frequently, which rapidly consumes their $1,000 coverage. Families like JoAnn Spencer’s, who has twin sons with cerebral palsy, now utilize their benefits for routine cleanings. Previously, many of these families avoided routine dental care due to costs.

The new coverage stems from an investment of $3.3 million in state and county funds alongside $7.4 million in federal dollars. Approximately 60,000 Arizonans qualify for ALTCS, encompassing various disabilities. For families like the Houstons, even partial coverage can represent a significant relief. Robert Houston expressed gratitude for the assistance, despite acknowledging that $1,000 may barely scratch the surface of necessary dental expenses.

As the demand for dental care continues to rise, particularly for those with deferred needs, awareness of the available benefits becomes critical. Earle emphasized the importance of informing families about their eligibility for coverage, aiming for improved access to necessary dental care.