Improve Early Grade-Level Reading

Expand Health Insurance

What Can Policymakers Do?

· Raise Medicaid and SCHIP income limits. Nearly 7 in 10 uninsured children are already eligible for Medicaid or SCHIP, but Illinois and Pennsylvania found that increasing eligibility levels also increases enrollment of children who were eligible under prior levels.

· Cover immigrant children with state-only funding. Washington state extended health coverage under SCHIP and Medicaid to immigrant and refugee children who are most likely nationally to lack health insurance coverage and access to preventive health services.

· Streamline enrollment, eligibility and re-enrollment. Louisiana demonstrated that the administrative costs of keeping ineligible children out can be far greater than the costs of providing coverage.[i] Effective streamlining strategies include:

· Coordinating with eligibility forms for other public services.

· Seamless enrollment in Medicaid and SCHIP.

· Electronic enrollment without required visits.

· Administrative searches to provide documentation.

· Presumptive eligibility while collecting needed information.

· Providing for continuous enrollment for a year without reviews.[ii]

· Ensure that Medicaid and SCHIP includes oral health, vision, and other services and that provider reimbursement ensures availability of service.

· Raise Medicaid payment rates. South Carolina exceeded dental provider enrollment targets by instituting a rate increase conditioned on an improvement in provider participation. Virginia doubled the number of Medicaid dental providers and the proportion of children receiving care increased from 24 percent to 35 percent.[iii]

· Ease the administrative burden. States like Michigan have successfully increased dentists’ participation by making Medicaid requirements, claim forms, and processes mirror commercial insurance. Alabama set up a toll-free number and automated system for verifying eligibility and submitting claims.[iv]

· Expand the supply of dental care. The Minnesota legislature established a grant program to increase access to oral health care for low-income and immigrant children, ages birth to 5 years, and their families.[v]

· Fully implement federally required Medicaid Early Periodic Screening, Diagnosis and Treatment (EPSDT benefits and expand SCHIP dental benefits to more closely mirror EPSDT. States like Tennessee have found that broad coverage of preventive and primary dental care as well as treatment, and elimination of cost barriers, improve the likelihood that low-income children will obtain appropriate dental care.[vi]

· Increase oral health education and patient support. Minnesota allows Medicaid payment for care coordination and patient education provided by qualified community health workers, including dental professionals.[vii] The California legislature budgeted for staff in the state’s social service agencies to coordinate dental services for individuals with special needs, reducing Medicaid dental costs for each patient by $240 per year.[viii]