A lawsuit on behalf of more than 400,000 Medicaid beneficiaries has been filed in federal district court in Grand Rapids alleging that the State is violating its obligations under the federal Medicaid Act by eliminating dental coverage for adult beneficiaries. Virtually all dental coverage for adults was eliminated in the Governor’s Executive Order this summer and was not restored in the FY 2010 budget. Plaintiffs are represented by Gary Gordon of the Dykema law firm.

Counsel for the plaintiffs and advocates allege that the termination of funding for adult dental benefits will put Medicaid beneficiaries at substantial risk for poor health outcomes, increase use of hospital emergency rooms for dental emergencies that could have prevented with routine care, and endanger the financial viability of the public dental health care clinic network. Several clinics are now considering closure. Moreover, in return for a savings of $5 million in state dollars, the state will lose $16 million in federal matching Medicaid funds that would have been available if the dental benefits had been maintained.

The loss of dental coverage has already had dire consequences. Officials with a dental clinic treating an elderly developmentally disabled woman in Northern Michigan said her condition was complicated by a severe dental infection that they were not able to treat effectively because of the cancellation of dental benefits. She died Oct. 7 in an Alpena hospital. The family of another Michigan man with disabilities alleges his teeth were extracted because they were so unstable they posed a risk of choking . However, the man is now unable to receive dentures. His food intake is severely limited and his health has been significantly affected by his inability to eat properly.

Many provider and advocacy groups have signed on to a letter prepared by the Medical Care Advisory Council urging the Governor to restore adult dental benefits. A proposed provider tax on physicians (through which, because of the availability of federal matching funds, the state would have been able to raise reimbursement rates for physicians who treat Medicaid beneficiaries and have additional funds to support the Medicaid program) that could have generated funds for Medicaid coverage of dental care was defeated in the state Senate.