Medicaid is the United States health program for people and families with low incomes and resources. It is a means-tested program that is jointly funded by the state and federal governments, and is managed by the states. People served by Medicaid are U.S. citizens only, including low-income adults, their children, and people with certain disabilities. Poverty alone does not necessarily qualify someone for Medicaid. Medicaid is the largest source of funding for medical and health-related services for people with limited income in the United States.
Children enrolled in Medicaid are individually entitled under the law to comprehensive preventive and restorative dental services, dental care utilization for this population is low. The reasons for low utilization are many, but a lack of dental providers who participate in Medicaid is a key factor. Group dental practices are some of the few dentists who accept children and adults insured with Medicaid. Few dentists participate in Medicaid – less than as half of all active private dentists in some areas. Low reimbursement rates, complex forms and burdensome administrative requirements are commonly cited by dentists as reasons for not participating in Medicaid.
Undercover research in Illinois reveals that dentists are far more willing to provide emergency care to children with private insurance than to kids with public insurance such as Medicaid.
Posing as mothers of a fictional 10-year-old boy with a fractured front tooth, six research assistants phoned 85 dental practices twice, four weeks apart, to determine the impact of insurance status on the practices' decision to schedule an urgent dental appointment, which may use dental equipment.
Even when calling Medicaid-enrolled dentists, just 68% of children with the Medicaid/Children's Health Insurance Plan were able to get an appointment, compared to all of the privately insured children. Non-enrolled dentists offered an appointment to only 7% of kids with public insurance despite the fact that Medicaid reimburses all emergency dental care.
Parents with public insurance who are turned away at a dental office can ask their primary-care physician for guidance or consult local dental schools, which often offer emergency dental care, Rhodes suggested.