Senate approves Walsh bill expanding dental coverage for pregnant women, diabetics

OLYMPIA – The state Senate approved a bill Wednesday that would expand dental coverage for some of the state’s neediest Medicaid recipients – and likely save the state money in the long run.

Senate Bill 5540, sponsored by Sen. Maureen Walsh, R-Walla Walla, would make it easier for pregnant women and diabetics to see dentists for preventive care. The three-year pilot project will test the effect of higher reimbursements against the state’s long-term costs.

The bill passed the Senate 49-0 and now moves to the House for consideration.

“Sometimes when we invest a little in prevention, we get a big return down the road,” Walsh said. “Not only will this bill improve the lives of those at highest risk for oral health problems, we may be able to avoid some of the costs we incur when dental disease becomes catastrophic.”

Although the state has provided dental coverage for adult Medicaid recipients since 2014, low reimbursement rates have made it difficult for them to obtain appointments. Dentists are paid just 29 percent of the amount they receive from private insurers, in some cases less than the overhead cost of maintaining a dental practice. In 2015, just 22 percent of adults eligible for Medicaid dental coverage were able to utilize it – often at the point where problems become acute.

The Oral Health Connections program launched by the bill would be managed by the state Health Care Authority and the Washington Dental Services Foundation, supported by Delta Dental, a major dental insurer. Reimbursements would be increased for diabetic patients and pregnant women, two groups at high risk for dental problems. Studies of commercially insured patients have shown significant savings when these two groups have received early treatment for gum disease and other problems.

The program is expected to save the state money after the second year of operation.