In 2009, California eliminated non-emergency adult dental services from its Medicaid program, Medi-Cal. This issue brief examines the impact of this policy change on Medi-Cal beneficiaries and the program’s dental providers.
Examining the year before and the year after the cuts were implemented (fiscal years 2008–09 and 2009–10), this analysis focuses on the following broad questions:
- How did the cuts affect dental expenditures? Were the expected savings to the state achieved?
- How did dental utilization change for both adults and children?
- How did dental provider practices change?
Looking at certified, continuously enrolled Medi-Cal beneficiaries who were not enrolled in dental managed care plans, the study found that in the first year after the cuts:
- Spending on adult dental benefits decreased.
- Spending on dental ambulatory care sensitive conditions (ACSCs) increased, though there is not sufficient evidence to claim that the increased spending was caused by limitations on adult access to preventive dental care.
- Adults in the blind and disabled aid categories were overrepresented among ACSC expenditures and had larger decreases in utilization than other adults.
- Decreased expenditures for Federally Required Adult Dental Services (FRADS) suggest that providers and/or beneficiaries may not understand that those services are still covered by Medi-Cal.
- Both expenditures on and utilization by children increased. Data do not indicate that the same children were seen more frequently.
As the study is based on only two years of data, it is too early to draw definitive conclusions about the long-term health and budgetary impacts of this policy change. However, the findings provide some initial outcomes and raise questions for future consideration regarding the oral health needs and access to care of Medi-Cal beneficiaries.
The complete issue brief is available under Document Downloads.