After months of lamenting the lack of adult dental services under the Medicaid program, I'm delighted to report that the program will expand in July.
Good news doesn't cross my desk that often and when it does, I get a little excited.For a while, it seemed that the program was whittled away every time budgets got tight.
Advocates, clients and representatives from the Division of Health Care Financing (which administers Medicaid and other low-income health programs) had all complained that the only two dental services available - extractions and temporary fillings - were simply not enough.
In July, covered services will be expanded to include oral examinations, X-rays, extractions and oral surgery, initial complete denture work, upper and lower acrylic partial dentures, anterior root canal therapy, anterior composite restorations, silver amalgam restorations and stainless steel crowns.
It's not much help to those who have already had teeth pulled because the work required to save them wasn't available earlier. But it's great news for future dental problems.
Proper dental care is important for a lot of reasons.
In the homeless population, for example, bad teeth not only lead to digestive and other health problems, but they can be so cosmetically unappealing that they hurt a search for employment and self-sufficiency.
Medical difficulties aside, the impact on self-esteem can be incredible, sabotaging efforts to achieve independence and self-sufficiency.
The mother of a mentally handicapped man told me about taking her son to a dentist because his teeth were so bad he couldn't even eat.
Because there was no adult dental program, to speak of, "they pulled several teeth," she said, "though they could have been saved with some extra work. The thing that makes it so bad is that they won't even pay for dentures."
During the last legislative session, she told lawmakers the story. "Please restore the dental program," she said. "I don't want to have to come back with a `blender bill.' "
She referred, of course, to the fact that without teeth, people can't eat solid foods and have to subsist on baby food or items processed in a blender.
There's more good news in the federal Medicaid program, as well.
Several months ago, I wrote about a woman named Ila Marie Goodey, who had contracted pulmonary polio as a child and was confined to a wheelchair, in need of oxygen support during the day and who relies completely on oxygen at night.
She is unable to work because if she earns a living she can't qualify for Medicaid to cover the services that very literally keep her alive.
And a job that offers medical insurance probably would never cover her physical condition because it is a pre-existing one.
She, too, testified before the Social Services and Health Joint Appropriations Committee, appearing to talk about the Medicaid spend-down program.
On the program, a one-person household is allowed to have an income of $289. If they have more than that, they refund the difference to the state in order to be eligible.
At that time, the income limit was $289. In Ila Marie's case, it meant that she had to pay for room, board, utilities and incidentals like clothing and toiletries with that amount of money.
Well, July is going to pull another magic stunt of sorts. The spend-down will go from $289 to $337. Assuredly, it's not a huge amount. In fact, it's well below the federal poverty line.
But it represents a significant percentage increase to the people it will affect - and these people are among the most vulnerable, with a myriad of health problems.
So when you hear me - or someone else - lambaste the last session of the Utah Legislature, remember that the lawmakers did, in fact, help make these changes possible.
Changes that will affect hundreds of lives for the better.