Wednesday, November 06, 2013

Senate votes to restore
Medicaid dental benefits

By Jamey Dunn

The Illinois Senate voted today to restore dental care benefits that were eliminated under recent cuts to the state’s Medicaid program.

Lawmakers approved Medicaid changes in 2012 aimed at cutting up to $1.6 billion in growth from the program. However, those savings have yet to be fully realized, and the state faces a lawsuit from unions over the use of an out-of-state contractor to verify Medicaid eligibility.

One of the most controversial pieces of that legislation, dubbed the SMART Act, was the elimination of dental care for adults except for in emergencies. The change meant that adult Medicaid recipients cannot get a check up or a filling, and basically all the state will cover is pulling a tooth if it gets infected. Supporters of House Bill 1516, which would restore benefits to the same levels as before the 2012 changes, said the cut went too far. “In this particular instance, it is believed that we overacted. And as is the power of this legislative body when we make those egregious mistakes that impacted so negatively on so many of our constituents, I think it’s incumbent upon us to correct them,” said Chicago Democratic Sen. Donne Trotter, the sponsor of the bill. “Not to just stick with the first thought that this is the only way to skin that cat — to become solvent again. But also let’s do it in a human way. ... The elimination of the adult dental programs certainly was more than just skinning the cat. It was beheading the cat.”

But opponents said lawmakers acted responsibly when they voted to get an unsustainable program under control. “We stepped up and said we’re going to change the program, and yes, that means to some extent we had to take some benefits away,” said Mattoon Republican Sen. Dale Righter. He said that doing that was difficult but necessary because the state was unable to reimburse providers on time. “It’s the reality. We had to spend less money. That means you have to giver fewer things away. You had to reduce the size of the program and reduce the services that were being afforded. Now we come back and we say, 'Well, except for this, and except for this and except for this.'” He added, “We’re either going to control the Medicaid program, or we’re not going to control the Medicaid program.”

Chicago Democratic Sen. Heather Steans, who sponsored the SMART Act, said she wishes the cuts to dental care were never included in the bill. She said that they cost more in the long run because those who cannot get preventative care end up in the emergency room or needing an oral surgeon. “It clearly was a mistake,” she said today. “It may be a cut in the short term to our budget. Long term, it clearly rises costs.”

 Trotter said the Illinois Department of Health and Family Services, which administers Medicaid, has the money in its budget to cover the cost of reinstating the program, which would be about $17 million for the reminder of the current fiscal year. “They are not new dollars that we are coming up with since July 1. It’s dollars that are already in their budget.” HB 1516 gives the department the authority to shift funds to the program. “Can we actually afford not to do this?” Trotter asked. “By not restoring these benefits to the program, we are devastating and decimating the viability of the people that we are sent down here to help.” The measure also would have to be approved in the House to reach Gov. Pat Quinn’s desk.

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