Medicaid patients struggle to find dental providers

BURLINGTON, Vt. (WCAX) – It’s hard enough right now to just find a dentist, but providers are calling it a perfect storm for patients who use Medicaid insurance. In the second part of her report, our Katherine Huntley looks at some of the possible solutions to the crisis.

It’s always been a struggle for Medicaid patients to get care, but a combination of dentists retiring early, supply chain issues, and a lack of support staff is causing some providers to stop taking new Medicaid patients. And the only way to reverse that trend, officials say, is more money and more help.

“The dentist that chooses not to see Medicaid patients is not discriminating against Medicaid clients, they are discriminating against the fee schedule,” said Dr. Chuck Seleen, a Winooski dentist.

The state says 78% of Vermont dentists accept Medicaid patients — one of the highest rates in the nation. But according to the American Dental Association, Vermont reimburses only around 50% of what private insurance pays.

The state raised the cap for adult Medicaid dental patients from $500 to $1,000 dollars in the past couple of years, but Seleen says that’s still not enough. ‘If you kept up with your care and you’re a Medicaid patient, that’s sufficient. But unfortunately, a lot of Medicaid patients that come in — they haven’t seen a dentist in years and you can hit that cap in one or two visits,” he said.

“We want to get to work and we have to roll our sleeves up and work harder than we’ve been working to make sure that this remains a priority for the state, so we can serve those most in need,” said Patrick Gallivan, executive director of the Vermont State Dental Society.

Back in February, the state used a $1 million pot of federal dollars to pay more for around 20 of the most common procedures, including cavity filling and root canals. Sen. Ginny Lyons, D-Chittenden County, says there is a bill in the works that would put significant money into dental hygenist loan repayment to help bolster the workforce. She says lawmakers next year hope to increase dental rates as part of an overall measure to boost Medicare primary care.

“I look at dentistry as a really significant part of primary care and so if we are going to be raising primary care rates going forward — which is in our health care reform bill — then we should also be considering this for our dental practitioners,” Lyons said.

State health officials say they are aware of these access issues which have become glaringly obvious during the pandemic. They encourage anyone struggling to find care to reach out for help. “We are doing what we can here to enhance rates where possible, increase access where possible, and allow people to call and get referrals if they can’t find a provider,” said Department of Health Access Commissioner Andrea De La Bruere.

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Medicaid patients struggle to find dental providers

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