In a master stroke of bad timing, the Dunleavy administration announced its search Tuesday for a “Dental Director” to identify just how difficult it is for the poorest people in the state to receive basic dental care.
The task became critical this week because Gov. Mike Dunleavy decided to make it impossible for tens of thousands of the poorest people in the state to get basic dental care under Medicaid, ending a program that began 13 years ago.
The Dunleavy Dental Director, to be paid up to $225,000 over the next three years, “will develop oral health program priorities in a written Oral Health Action Plan with assistance from tribal programs to identify gaps in oral health services to Alaska’s most vulnerable populations.”
The work is 20 hours per month for up to three years, about $300 an hour.
With the veto, this is the second time this summer that Dunleavy rejected the attempt by the Legislature to preserve the cost-effective program that helps the most vulnerable adults. He has widened the gap in oral health services and now he wants to study it.
His veto cuts $8 million in general funds, which leads to the loss of $18.73 million in federal funds for Alaska. The governor has not explained why the $18.73 million should be forfeited or how he made this decision.
More importantly, Dunleavy’s veto means the end of a program that has been helping people keep their teeth since it was signed by former Gov. Frank Murkowski in 2006. The cap has always been $1,150 per person per year.
The program came about in response to a “tremendous health care problem facing our state,” former health commissioner Joel Gilbertson said at the time.
The loss of dental coverage now for about 40,000 of the poorest people in the state will have a major impact on their lives and add to a tremendous health care problem for the state. People with missing teeth find it hard or impossible to get jobs and get off welfare.
In addition, untreated tooth decay increases the risk of diabetes, heart disease and other illnesses.
In a startling admission, Donna Steward, deputy commissioner of the health department, told a legislative subcommittee March 19 that there was no analysis of what the end of the program would mean to the health of thousands of people getting services or to state finances.
“We have not done research as to what the results may be if individuals in Alaska Medicaid recipients do not receive dental care. We have not done any type of research on that,” she said.
The Dunleavy decision will probably cost the state much more money in the long run because people with bad teeth will wait until the decay gets so bad that an emergency room visit is justified. That visit will be covered under Medicaid.
A state document from more than a decade ago presented the logic for prevention: “The coverage expansion was added because infections in the mouth are no different than infections in other parts of the body. Dental infections cause pain, lost time at work and missing teeth can affect employability. Waiting for dental emergencies often results in more expensive dental care and limits the dentist’s ability to address dental problems that will result in future dental emergencies.”
The Alaska Dental Society, calling for the preservation of the service earlier this year, said the program prevents more expensive dental problems, “restoring dignity and appearance to Medicaid recipients and helping them to transition away from public assistance.”
There is more than a little irony in that the request for proposals for the Dunleavy Dental Director is linked to a report that mentions the importance of the dental care Dunleavy has eliminated.
The Legislature should override the veto, keeping this program that helps thousands of Alaskans keep their teeth.
Dermot Cole is a longtime Alaskan, an author of several history books, and a former Daily News-Miner staff columnist who now writes an occasional column on Alaska politics and history. His email address is firstname.lastname@example.org.