Fallout from State Budget Dispute; Money for Low-Income Dental Care Is Caught in Gridlock; Lawmakers Approved the Medicaid Expansion in May, but Gov. Jay Nixon Withholds Funding, Citing a Revenue Crunch

By Jordan Shapiro; > ; Samantha Liss; > | St Louis Post-Dispatch (MO), September 21, 2014 | Go to article overview

Fallout from State Budget Dispute; Money for Low-Income Dental Care Is Caught in Gridlock; Lawmakers Approved the Medicaid Expansion in May, but Gov. Jay Nixon Withholds Funding, Citing a Revenue Crunch


Jordan Shapiro; > ; Samantha Liss; >, St Louis Post-Dispatch (MO)


With the dust settled on Missouri's contentious veto session, about 300,000 low-income Missouri adults are still waiting to hear whether their government-funded health plan will cover the costs of dental care.

When the Republican-controlled Legislature voted in May to restore dental benefits for most adult Medicaid recipients, it seemed like a slam dunk.

Republicans had cut the dental benefits from Medicaid nine years earlier, but this year rallied behind restoring dental coverage as a means to promote cost-effective preventive care and oral health. Democrats, who lamented the earlier cuts, had been advocating to restore the funding for years.

"You should have less cost because people can get some extra dental care for a couple hundred dollars a year as opposed to spending thousands of dollars in the emergency room," said Rep. Sue Allen, R-Town and Country, one of the proposal's chief backers.

But the legislative accord over dental coverage was threatened by a budget dispute with Gov. Jay Nixon, a Democrat, over tax breaks for certain industries and lower-than-anticipated state revenues.

And even though lawmakers sustained many of Nixon's vetoes of tax- break legislation for businesses such as dry cleaners, power companies and data storage centers, the funding is still in limbo.

That's because Nixon continues to withhold the $17.8 million in state general revenue for dental services from the current state budget, preventing it from being spent. That's leaving some providers in a lurch.

"What we probably have are a lot of really good social services and safety net providers who could finally offer services to people who need them, and now they realize that it is not going to happen," said Sidney Watson, a St. Louis University School of Law professor.

This spring a $25 million, 79,000-square-foot dental clinic will open near Lafayette Square to help improve access to oral health care for Missouri families.

The clinic, part of A.T. Still University, will work in partnership with Grace Hill Health Centers to provide dental care to individuals, focusing on low-income patients. Patients will be able to pay on a sliding scale based on income.

Christopher Halliday, dean of Missouri School of Dentistry & Oral Health at the university, said the restored Medicaid dental funding would allow his students to have a greater pool of patients to draw from and treat.

At a groundbreaking in April, Nixon lauded the investment, citing its benefit for the area's most vulnerable and the addition of about 80 jobs in St. Louis.

Vicki Wilbers, executive director of the Missouri Dental Association, was hopeful in May when the Legislature approved the dental funding but said she was reluctant to consider it a done deal.

"We weren't celebrating quite yet in May," Wilbers said. "We're confident this is a priority item for the governor, and we are still hoping the funds will eventually be released."

"It is desperately needed," Wilbers said. …

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