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Medicaid Lacking empathy: a dental story

Kaicie Boeglin

Opinions Editor

Photo by Kaicie Boeglin

Rhode Island is a state that mandates individuals to have insurance, yet state insurance doesn’t always cover the individual. Oral health including all types of dental services are essential to living a healthy life. Strong teeth and clean gums promote good health throughout one's lifetime. The extraction of wisdom teeth is one of the most common, basic and easiest oral procedures but insurance through RI’s Medicaid plans do not cover any part of it. In a state that demands citizens to have insurance, why won’t basic state insurance help an individual on behalf of oral and dental work?

If a Rhode Islander doesn’t have health coverage they can pay penalties when filing their personal state income taxes. All mandate information can be found on the HealthSource RI website. The fee is calculated either as 2.5% of your yearly household income or per person, whichever amount is deemed higher. Rhode Island utilizes HealthSource RI as their health insurance marketplace for comparing and contrasting coverage plans. Through HealthSource RI, the state offers a Medicaid program with dental and medical insurance plans through the Neighborhood Health Plan of Rhode Island, Tufts Health Plan, UnitedHealthcare and RIte Smiles. Medicaid is a program which offers free or low-cost health coverage for residents with limited income and resources or showing financial distress. Although Medicaid covers basic medical visits both pediatric and adult, as well as basic dental cleanings and fillings, all oral surgeries are not covered.

Medicaid is paid through the state taxes taken out of one’s paycheck. Therefore an individual’s hard earned money is still going towards paying for health coverage, so where is that money? Why are people financially struggling, who are covered by Medicaid, paying fully out of pocket for their surgery that was declared medically needed? According to Cranston oral surgeon, Dr. Martin Elson DDS, oral practices across the state refuse to accept state dental insurance because the state lacks empathy and proper reimbursement. The amount of money the state refunds to the oral practice doesn’t cover the equipment costs, thus neglecting the cost of anesthesia and time of the surgeon. Dr. Elson goes on to explain it isn’t that the state’s surgeons can’t take Medicaid, but rather their practices are avoiding money issues that cascade into future involvements with the Internal Revenue Service.

The overarching ethical issue is in a state that mandates all residents regardless of financial stature to get health care coverage. Basic state coverage through the Medicaid program should cover at least a small percentage of procedure costs, seemingly because this program was put in place for the residents in financial hardship. Picture being a low-income individual sprung with news of needing surgery and struggling to find a surgeon that takes your healthcare coverage. Low-income families and individuals struggle enough to supply themselves with a good life; if money is being stripped from each of their paychecks for state insurance, then that state insurance should be of use when needed.


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