The Tampa Bay Healthcare Collaborative (TBHC) met with oral health stakeholders from across the country April 10-12 in Chicago to discuss opportunities to engage with their constituents to protect access to healthcare coverage and services, especially those related to oral health. The group is made up of consumer-focused organizations supported by the DentaQuest Foundation through the Oral Health 2020 initiative, a movement to achieve oral health milestones, like improving the value and perception of oral health, by 2020. TBHC has been working with this group via its Achieving Oral Health Equity initiative since 2015.
In light of major proposed health policy changes at the federal and state levels, these stakeholders are gearing up to play a key role in educating policymakers and consumers about the potential impacts these reforms could have.
As of now, efforts to repeal parts of the Affordable Care Act (ACA) via the American Health Care Act (AHCA) have been stalled in Congress (more information about the AHCA can be found in an earlier blog). However, President Trump and Health and Human Services Secretary Tom Price will likely pursue administrative actions to weaken the ACA and Medicaid. These could include reducing funding to support ACA enrollment, and encouraging states to undertake efforts to change Medicaid programs.
Members of the Florida House are currently pursuing legislation that would impose premiums and work requirements in Medicaid. While the premiums would be low, (between $10 and $15 per month), they would likely be unaffordable to many, forcing them to go without insurance. For example, working parents must make less than $7,300 a year to be eligible for Medicaid in Florida. For these families, $120 per year in premium costs is a significant additional expense.
Work requirements could also force some Medicaid enrollees to become uninsured. Florida’s Medicaid program strictly limits eligibility to those who would have a difficult time finding and maintaining employment – including those who have serious disabilities, are pregnant, and children. More than half of individuals who fall outside of those categories are already working.
Overall, premiums and work requirements would likely reduce Medicaid enrollment in Florida, leading many to seek care in emergency departments as a last resort. As a result, an effort intended to save money could end up being a net money loser. Hospitals, local governments, and ultimately taxpayers will be left to deal with the uncompensated care costs that are incurred from uninsured people seeking care in expensive settings.
If implemented, these changes could significantly diminish access to and affordability of healthcare services, including oral health. Although Florida does not offer a comprehensive adult dental benefit in its Medicaid program, scaling back Medicaid coverage could reduce the number of people receiving preventive care, especially children. Studies show that children are more likely to get covered when their parents have coverage, so scaling back Medicaid eligibility for parents could have an adverse effect on kids. Additionally, one of the Medicaid programs at risk of being cut under the Medicaid financing changes proposed under the AHCA, the Early and Periodic Screening, Diagnostic, and Treatment benefits (EPSDT), covers most dental services for children.
Over the coming weeks, additional resources and tools will be developed to continue to track policy developments, and information will be shared via TBHC’s social media and website platforms. For more information about how to plug into advocacy efforts to protect coverage and care in Florida, check out our partner, Florida Voices for Health, who is creating and disseminating the most up-to-date resources and opportunities to take action.
Additional resources are available from Families USA, the Children’s Dental Health Project and Community Catalyst to help you make your voice heard, including talking points for talking about the impact proposed reforms could have on vulnerable populations, sample emails to legislators and tips for holding town hall meetings to raise awareness about the importance of protecting access to coverage and care.