It is 2014 and the inaugural year of the Affordable Care Act implementation. Curious if dentistry has etched (primed and bonded) its way into ACA? I can tell you, it has. The watchword in regards to our field is “prevention”—detailed in the 21 oral health provisions of ACA. Tied closely with prevention, we may see pediatric dentistry and Medicaid bearing the brunt of the dental changes. Although detailed, the bill is surprisingly digestible. However, if you’ve avoided the daunting task of reading the ACA, you may have a few questions. Let me decode those for you here:
- Is it true that all pediatric patients are required to carry some form of dental coverage? Not completely. The essential health benefits (EHB) are required to include dental benefits for those under 19. However, parents are not required to purchase dental plans under a new ruling. It is projected that by 2018 an estimated 8.7 million children will have gained dental coverage. Keep in mind that there may be more changes to this ruling in the future.
- Medicaid is expanding its coverage to 138% of the Federal Poverty Line, is my state expanding coverage? It depends on your state. Twenty-five states (plus the District of Columbia) have chosen to expand Medicaid coverage. Check out this map to see your state’s most recent decision: Where the States Stand on Medicaid Expansion.
- The ACA is projected to increase Medicaid dental visits by 10.4 million visits per year by 2018, will there be a subsequent increase in reimbursement rates for dental procedures? No, there is no increase in dental Medicaid reimbursement rates under the ACA. A “Medicaid Parity” provision is included for family medicine, general internal medicine, pediatric medicine and certain subspecialists. The specific specialties and subspecialties of medicine can expect to see an increase of approximately 73 percent of their reimbursement rates for Medicaid.
- Will the Medical Device Tax be implemented in Dentistry? Yes. Dental devices are taxed by the Medical Device Tax. The Medical Device Tax is anticipated to financially support the Affordable Care Act. Some have expressed concern of a “trickle down effect” making its way to the provider and patient as the manufacturers increase prices to offset the tax. ASDA opposes this tax and invites dental students to use Engage to encourage their lawmakers to repeal the tax.
~Courtney Worlinsky, Florida ’14