Oral Health Problems Linked to Medicaid Coverage Loss for Postpartum Individuals

US: Over a million Americans, including postpartum parents, have been stripped of their Medicaid coverage, depriving them of essential dental care that played a crucial role in safeguarding their health during and after pregnancy. 

The Medicaid coverage provided varies across states, with federal law mandating dental benefits for patients up to the age of 21 but lacking such requirements for adults. Consequently, not all states include dental benefits in their Medicaid coverage for adults.

Implications of Medicaid Disenrollment on Access to Care

The removal of Medicaid coverage, particularly without alternative options, poses challenges in accessing necessary care, including dental services. Robin Rudowitz, Vice President and Director for the Program on Medicaid and the Uninsured at KFF, noted that individuals who lose Medicaid and lack other coverage are likely to encounter difficulties in accessing care, including dental care. A survey conducted by KFF revealed that over 40% of individuals solely relying on Medicaid coverage expressed uncertainty about where to seek alternative coverage or the possibility of becoming uninsured.

Postpartum dental care is critical as the oral health of the birthing parent significantly influences the oral health of the child. Although Medicaid covers dental care for enrollees under 21 in every state, the extension of dental benefits to adults is not universal. Consequently, even if a parent reapplies for Medicaid coverage after the 60-day postpartum period, dental benefits may no longer be included. 

While 33 states have extended postpartum care for at least 12 months, in line with the Centers for Disease Control and Prevention‘s recommendation, states such as Mississippi and Texas have not yet implemented such extensions or expanded Medicaid eligibility. This situation leaves postpartum individuals in these states particularly vulnerable.

Risks of Poor Oral Health During Pregnancy 

A recent report released by CareQuest Institute for Oral Health highlights the inherent risks associated with poor oral health during pregnancy. Pregnant individuals face hormonal changes that increase the risk of oral diseases, while untreated dental conditions can exacerbate diabetes and hypertension. Furthermore, inadequate oral health during pregnancy is linked to negative birth outcomes, including preeclampsia. These risks are compounded for Black women, who already face a 27% higher likelihood of severe pregnancy complications compared to their White counterparts.

New York Medicaid to Expand Dental Coverage for 5M People

Recognizing the importance of oral health in overall well-being, the American Dental Association (ADA) has advocated for maternal oral health to be considered an essential health benefit for one year postpartum. George R. Shepley, the President of ADA, highlights the significance of good oral health during pregnancy and postpartum, as untreated dental issues can harm both the mother and the baby.

Addressing Disparities in Dental Healthcare

Expanding dental healthcare benefits could help alleviate disparities among people of color, who face greater challenges in accessing dental care compared to White individuals. Myechia Minter-Jordan, President and CEO of CareQuest, notes that Black and Hispanic adults report significantly higher rates of never having visited a dentist, with those living in economically depressed areas having a higher risk of tooth decay compared to their White counterparts.

To mitigate these risks, the CareQuest report suggests policy changes, including extending postpartum Medicaid dental coverage for birthing parents from the current 60-day minimum to at least 12 months. Several states, such as Maryland and Tennessee, have already implemented this provision and have subsequently extended dental care to all adult Medicaid enrollees this year.

The loss of Medicaid coverage for postpartum individuals, particularly regarding dental care, highlights the potential long-term consequences for their health and well-being. Policy changes and expanding access to dental benefits are crucial steps towards addressing these disparities and ensuring comprehensive healthcare for all, especially vulnerable populations.