Gov. Kasich vetoes dental Medicaid pilot project, access to dental care initiative

On June 30, Gov. John Kasich signed the state budget bill into law for fiscal years 2016-17.  He exercised his line item veto authority on 44 items in the state budget, including two significant access to dental care provisions.

This past spring, during ODA’s Day at the Statehouse and through testimony in the Ohio House of Representatives Finance Subcommittee on Health and Human Services and the Ohio Senate Medicaid Committee, the ODA, its advocacy team and member dentists made the case for increased funding in the state’s Medicaid program for dental services.  The ODA explained that dental Medicaid rates have not been raised since 2000 and that currently Medicaid reimburses dentists at less than 40 percent of their regular fees. A recent ADA study shows that Ohio’s dental Medicaid rates are 41st out of 50 states (10th from the bottom). 

On June 26, the General Assembly passed the final version of the budget bill, which included funding for a demonstration pilot project in 16 rural Appalachian Ohio counties whereby Medicaid would reimburse dentists at 65 percent of dentists’ regular fees as determined by the most recent ADA fee survey. The intent of the pilot project was to determine the impact of Medicaid paying at rates closer to market fees. Other states that have raised fees to this level have experienced a significant improvement in Medicaid participation and utilization and in access to dental care for the underserved.  Unfortunately, on June 30, 2015, Kasich exercised his line item veto to nix the pilot project.

Kasich also vetoed a provision that would have created the “Hope for a Smile” program.  Among other things, this program would have funded a mobile dental unit for use statewide in providing dental care to underserved Ohioans.  The program would have also allowed dentists who provide free care to underserved Ohioans to deduct the value of that care from their state income taxes. 

ODA president Dr. Tom Paumier expressed disappointment in the governor’s vetoes, noting that the Ohio Department of Health has branded dental health as the “number one unmet health care need in Ohio” and recently recommended paying higher Medicaid rates for dentists providing care to Medicaid patients in Appalachian counties. “It is surprising that Governor Kasich would veto the dental Medicaid pilot project since the idea for it came from the Ohio Department of Health’s report,” Paumier said. In 2012, the Ohio Department of Health published “Hills and Valleys: The Challenge of Improving Oral Health in Appalachian Ohio,” which recommended testing fee differentials for primary care dentists practicing in Appalachia and expanding the use of mobile dental systems to increase access in underserved areas.

The final budget included an increase in the dental Medicaid budget of $1.5 million in fiscal year 2016 and $3 million in fiscal year 2017, which amounts to about a 1 percent overall increase.