Shaking Up the Dental Safety-Net: Elimination of Optional Adult Dental Medicaid Benefits in California
Center Researchers Beth Mertz and Cynthia Wides published this article in the February 2014 Supplemental Issue of the Journal of Health Care for the Poor and Underserved. This issue celebrates the 25th year of the journal's publication and focuses on the Patient Protection and Affordable Care Act. The paper presents a qualitative study on the impact of the cuts on the safety-net workforce.
In July 2009, California eliminated funding for most adult non-emergency Medicaid dental benefits (Denti-Cal). This paper presents the findings from a qualitative assessment of the impacts of the Denti-Cal cuts on California's oral health safety-net. Interviews were conducted with dental safety-net providers throughout the state, including public health departments, community health centers, dental schools, Native American health clinics, and private providers, and were coded thematically using Atlas.ti. Safety-net providers reported decreased utilization by Denti-Cal-eligible adults, who now primarily seek emergency dental services, and reported shifting to focus on pediatric and privately-insured patients. Significant changes were reported in safety-net clinic finances, operations, and ability to refer. The impact of the Denti-Cal cuts has been distributed unevenly across the safety-net, with private providers and County Health Departments bearing the highest burden.