Bevin will reverse cuts to Medicaid dental, vision services, state says

Deborah Yetter | Courier Journal

Show Caption Hide Caption 'It's just wrong:' Susan Wells talks about how Medicaid cuts affected her Wells was one of nearly 400,000 Kentuckians enrolled in Medicaid who lost their dental benefits after Gov. Matt Bevin made cuts.

This story has been updated to include additional comments.

In a surprise reversal, Kentucky officials have announced the state will rescind Medicaid cuts that eliminated dental, vision and non-emergency transportation services for nearly 400,000 Kentuckians.

In a statement released late Thursday, the Cabinet for Health and Family Services announced that "we have begun the process to reinstate vision and dental coverage, as well as non-emergency transportation services."

The statement said officials still hope to get federal approval for Bevin's planned overhaul of Medicaid that would change dental and vision benefits for many "able-bodied" adults but said such approval won't happen "as soon as we had hoped."

The cabinet said it is reinstating benefits for now "to avoid a pro-longed coverage gap."

Advocates were delighted that dental benefits will be restored.

"That is such good news," said Jennifer Hasch, manager of dental services for the Shawnee Christian Healthcare Center in West Louisville. "I think people are going to be thrilled. I think it's weight lifted for our office, both for our patient population and our team."

House minority leader Rocky Adkins, a Sandy Hook Democrat, also hailed the change. He said the House Democrats objected to the cuts as unnecessary and an "immediate hardship."

"I'm hopeful that our citizens will not be faced with the devastation of losing these benefits again," Adkins said.

Terry Brooks, executive director of Kentucky Youth Advocates, said dental, vision and transportation benefits are important to families.

"Parents must be healthy to provide for their families and care for their children," he said.

Sources told the Courier Journal that the state plans to reinstate the benefits by Aug. 1, but will make them retroactive to July 1, so people can visit the dentist or eye doctor during July and the provider can bill Medicaid for the services. The sources asked not to be identified, saying they were not authorized to comment.

The abrupt cuts effective July 1 created an uproar across Kentucky, catching patients and providers off guard, causing the most disruption in dental services. Dentists were forced to turn away hundreds of patients who had lost benefits overnight, many suffering from pain from severe infection and dental abscesses.

While health advocates say all three services cut — dental, vision and transportation — are important, the loss of dental services were most critical because of the very poor dental health of some Kentuckians and the fact that dental abscesses and infection can be life-threatening.

Must read: 'I want to have my teeth': Bevin's Medicaid cuts leave Kentuckians in pain

"This is a big problem," said Dr. Chad Street, a Pikeville oral surgeon who has had patients wind up in intensive care from dental infection that spread through their bodies. "Patients are going to be in pain. Patients are going to end up in the hospital or in the worst case scenario, die from infection."

The sudden reversal of the cuts comes as providers are still trying to adjust to the changes and inform patients about what's going on.

Hasch said her clinic saw patients Thursday who came in for ongoing care for dental treatment and had no idea that they had lost Medicaid dental benefits.

For now, the non-profit clinic is treating Medicaid patients regardless of ability to pay but would have been forced to reassess that by Aug. 1, she said, possibly charging patients on an ability to pay basis. If coverage is reinstated to July 1, the clinic will be able to bill for all dental services it provided in July, easing financial pressures, she said.

"I'm really relieved," she said.

Dentists told the Courier Journal they had to cancel appointments this month for patients who had waited months for relief from decayed teeth and abscessed gums, some in need of what dentists call "full mouth extractions." They said patients showed up with no idea they had lost Medicaid dental coverage and were upset and angry.

Some patients found their benefits cuts while they were in the middle of treatment, including Susan Wells, of Louisville, who had been having decayed teeth extracted when the cuts were announced.

She had five teeth left to pull when the state announced it was eliminating dental services for the "able-bodied" adults, mostly those among about 500,000 people added Medicaid under the Affordable Care Act.

"When that came up, I said 'I might as well die,'" said Wells, 51. "I cried. I was so angry."

Wells got the care she needed on July 11 through the Shawnee Christian Healthcare clinic

State Medicaid officials told a legislative committee Wednesday the changes left around 373,000 people with no routine dental or vision coverage.

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The cuts came two days after a federal judge struck down Bevin's plan to overhaul Medicaid, adding work requirements, premiums and other rules.

The plan would have placed about 460,000 "able-bodied" adults in a plan called Kentucky HEALTH with more limited benefits that did not include dental and vision services. Individuals could earn points toward paying for dental and vision care through activities such as on-line classes or volunteering through a system called "My Rewards."

The Cabinet for Health and Family Services said in a July 1 statement that immediate cuts in dental, vision and transportation benefits were required "to compensate for the increasing costs of expanded Medicaid" and were "an unfortunate consequence of the judge's ruling."

Adam Meier, cabinet secretary, repeated that claim in a letter Wednesday to House Democrats.

"It is important to understand that the decision to discontinue dental and vision benefits for able-bodied adults in the Kentucky HEALTH population immediately was not one that we made — it was one that was made for us by a judge in Washington D.C.," his letter said.

Health law advocates and an outside expert say the June 29 ruling by U.S. District Judge James E. Boasberg, of Washington, D.C., does not require any such cuts.

"There is nothing stopping the state from continuing to offer dental and vision as they had done," said Marybeth Musumeci, a lawyer and Medicaid expert with the Kaiser Family Foundation, a nonprofit health policy organization.

Deborah Yetter: 502-582-4228; dyetter@courierjournal.com; Twitter: @d_yetter. Support strong local journalism by subscribing today: courier-journal.com/deborahy.