The bipartisan debt ceiling agreement reached by Congress and the White House this week has significant implications for federal health programs and specifically, investments in oral health. While the details of the cuts remain unclear, the agreement calls for nearly $1 trillion in cuts to discretionary spending and at least another $1.2 trillion in cuts to be determined by a 12 member Congressional "Super Committee" by November 23rd.

 

The cuts in discretionary spending will have a major impact on future spending on a range of oral health programs and initiatives maintained by agencies like the CDC and HRSA. Such programs strive to improve our country's oral health infrastructure and ensure that families who would otherwise go untreated get the care they need through the vital safety-net system

 

While Congress preserved programs like Medicaid in the short-term, the agreement creates a Congressional Super Committee to find at least $1.2 trillion in cuts (with a goal of $1.5 trillion), placing programs like Medicare, Medicaid, and the Children's Health Insurance Program (CHIP) in jeopardy. Fortunately, if the Super Committee cannot reach an agreement, there are a number of programs that will be protected from the $1.2 trillion in automatic across the board spending reductions that will occur by November 23 if the Super Committee deadlocks. Medicaid and CHIP are both protected from these automatic reductions.

 

While we continue to support efforts by the Congress to get our country on a path to more responsible spending, we must also remain vigilant in our message that significant savings cannot be found our country's critical health programs.

 

It is reassuring that programs like Medicaid and CHIP will not be subject to the automatic spending cuts, yet they are still very vulnerable in the negotiations that will occur among the Congressional Super Committee. You have worked hard in recent months to protect the programs that provide essential health and oral health coverage to millions of American families. Now, however, is not the time to rest. In order to keep Medicaid, CHIP, and other vulnerable oral health programs safe, contact your legislators and let them know that future deficit-saving should not come on the backs of America's most vulnerable families.

 

While the federal government was able to narrowly avert financial disaster over the debt ceiling, states continue to seek ways to balance their budgets.  According to Kaiser Health News, a number of states are seeking waivers from federal regulators to make significant cuts or changes to their Medicaid programs, an unsettling trend that could threaten access to care for many families.

California, for example, is asking the federal government for permission to implement changes to California's Medicaid program (Medi-Cal) that could make it even more difficult for the state's most vulnerable families to get the care they need.  The state budget, recently signed by Gov. Brown cuts about $1.4 billion from Medi-Cal.  Specifically, proposed changes to the program include reducing rates paid to Medi-Cal providers such as physicians and pharmacies by 10 percent, placing an annual limit on doctors visits, and charging co-pays for for doctor visits and other services including dental visits.

Not only could these changes affect families' access to care, but they also create a direct disincentive to seek dental care among families that are at highest risk for dental problems and have the least access.

Such changes to Medicaid would need to be approved by the Centers for Medicare and Medicaid Services (CMS).  Provider groups along with children's health and oral health advocates in California and other states are opposing these changes by letting CMS know that cuts to Medicaid would not ensure families sufficient access to the care they need.

If you are interested in learning more about these waivers, contact us.