PRINTER'S NO. 3409
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE RESOLUTION
No.
799
Session of
2020
INTRODUCED BY INNAMORATO, GAYDOS, RABB, WEBSTER, MURT, KINSEY,
LONGIETTI, DiGIROLAMO, SCHLOSSBERG, FREEMAN, OTTEN, CIRESI,
READSHAW, VITALI, HILL-EVANS, DEASY, NEILSON, YOUNGBLOOD,
PICKETT, FRANKEL, BERNSTINE, RAVENSTAHL, HOHENSTEIN, BURGOS,
O'MARA, ULLMAN, T. DAVIS, ROEBUCK, LEE, SAMUELSON, SOLOMON,
HARRIS, ROTHMAN, DONATUCCI, WARREN, KORTZ, KRUEGER, DRISCOLL,
HERSHEY AND JAMES, MARCH 4, 2020
REFERRED TO COMMITTEE ON HEALTH, MARCH 4, 2020
A RESOLUTION
Directing the Legislative Budget and Finance Committee to
conduct a study and issue a report on the fiscal and human
effects resulting from the Department of Public Welfare, now
the Department of Human Services, changes in 2011 to adult
dental coverage under medical assistance.
WHEREAS, Medical and social research demonstrate that dental
care is clinically and vitally important for everyone and
significantly affects overall health status, employability and
social inclusion; and
WHEREAS, Dental diseases are caused by bacterial infections
spread through contact with saliva and, without treatment, are
progressive in nature and pose a serious threat to public
health; and
WHEREAS, Lack of dental care is a recognized indicator of
greater likelihood of chronic illnesses and poor health
outcomes; and
WHEREAS, Preventive dental care and treatment to maintain
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health are more financially efficient forms of care that reduce
expenditures to treat other chronic and serious conditions; and
WHEREAS, Under the authorization of the amendments to the
Public Welfare Code in Act 22 of 2011 and the Department of
Public Welfare Bulletin relating to medical assistance dental
benefit changes, dated September 26, 2011, dental coverage for
some forms of early treatment of adult dental disease offered
under medical assistance were discontinued; and
WHEREAS, The Department of Public Welfare was redesignated as
the Department of Human Services by Act 132 of 2014; and
WHEREAS, Many Pennsylvanians, including those residents
enrolled in medical assistance, living in rural areas or
experiencing a disability are frequently unable to find or see a
dentist or pay for dental care; and
WHEREAS, Pennsylvanians with disabilities have been
disparately impacted by the coverage shift; and
WHEREAS, Dental patients now struggle to have complete health
care, and providers are less likely to participate in medical
assistance when denied the ability to resolve the disease; and
WHEREAS, Similarly situated states that also reduced adult
dental coverage under Medicaid reported increases in dental-
related emergency department visits and costs for adults; and
WHEREAS, Limiting adult dental coverage through Medicaid can
cause patients to seek emergency care in hospital emergency
departments and urgent care centers; and
WHEREAS, Hospital emergency departments are not trained or
equipped to definitively resolve dental diseases and often
provide only palliative care or antibiotics for temporary relief
of chronic and acute bacterial infections; and
WHEREAS, Health care providers in hospital emergency
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departments are much more likely to prescribe opioids to
patients with dental conditions, with research indicating that
38% of Medicaid patients who received care in the emergency
department filled an opioid prescription, compared to 11% who
went to a dentist; and
WHEREAS, This data suggests that emergency health care
providers and dentists diagnose oral health problems
differently, which can lead to unnecessary opioid use; and
WHEREAS, Although the objective of cutting adult dental
coverage through medical assistance was to limit program costs
for the Commonwealth, repeated emergency department visits, lack
of employability and poorer health outcomes caused by untreated
dental disease have impacted overall health care costs in this
Commonwealth; therefore be it
RESOLVED, That the House of Representatives direct the
Legislative Budget and Finance Committee to conduct a study and
issue a report on the fiscal and human effects resulting from
the Department of Public Welfare, now the Department of Human
Services, changes in 2011 to adult dental coverage under medical
assistance; and be it further
RESOLVED, That the Legislative Budget and Finance Committee
conduct an economic cost-benefit analysis of the 2011 cuts to
dental benefits under Medicaid; and be it further
RESOLVED, That the Legislative Budget and Finance Committee
examine county-level costs of dental and dental-related
conditions presented in local emergency departments and
associated inpatient admissions and ambulatory surgeries; and be
it further
RESOLVED, That the Legislative Budget and Finance Committee
examine costs of dental and dental-related conditions that are
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related to reduced access to comprehensive dental care; and be
it further
RESOLVED, That the Legislative Budget and Finance Committee
examine the number and increased costs of opioid prescriptions
associated with acute dental pain and subsequent potential for
addiction and overdoses; and be it further
RESOLVED, That the Legislative Budget and Finance Committee
study its findings and make recommendations as to what will
preserve the quality dental services already in place, the
feasibility of expanding Medicaid dental care coverage and the
potential for savings realized from integrating dental care into
medical settings; and be it further
RESOLVED, That the Legislative Budget and Finance Committee
compile a report based on its findings and recommendations and
submit its report to the House of Representatives within 18
months of the adoption of this resolution.
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