Pennsylvania Medical Assistance : Evaluation of Children ’ s Access to Dental Services
By Monica Costlow , JD and Dr . Judith Lave
Introduction
A recent report by the Pew Center on the States estimates that 17 million low-income children in the United States , about one in five of all those between the ages of one and eighteen , go without dental care each year . 1 The same report assessed all 50 states and the District of Columbia on ensuring dental health and access to care for disadvantaged children . Pennsylvania , along with eight other states , received a poor grade . In this article , we examine dental care for disadvantaged children in Pennsylvania , specifically focusing on the Medicaid program . Eligibility criteria , covered dental services , expenditures , and access to and quality of services are discussed . We describe initiatives undertaken by the state and examine policy options for further improvement . We find that the Medicaid program in Pennsylvania plays a very important role in the provision of dental services to low-income children . 2
Medicaid Importance
The Medicaid program , called Medical Assistance in Pennsylvania , is the underpinning of the health care safety net . Medicaid was created by Congress in 1965 under Title XIX of the Social Security Act . It pays for medical and long-term care for eligible low-income American citizens and certain legal immigrants . Financed by the federal government and the state , Medical Assistance provides health care coverage – the key to accessing care – for the Commonwealth ’ s neediest , most vulnerable residents , while paying providers such as hospitals , dentists , doctors , and pharmacies for treatment that would otherwise go largely uncompensated . Children can qualify for Medical Assistance by either meeting an income requirement or having a disability determination . As shown in Table 1 , income eligibility is specified in terms of the federal poverty level ( FPL ) and varies by age and family size . For example , children
September / October 2010 • Pennsylvania Dental Journal
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