In Victory, Medi-Cal Dental Patients Still Face Challenges

Jun 27, 2013

Gloria Sams cools down her pet birds on her balcony in Santa Cruz.

Today Governor Jerry Brown signed the new state budget. It partially reinstates adult dental benefits for the poor; the program that was slashed four years ago.  But even in this victory for patients in need, challenges lie ahead. 

On the balcony of Gloria Sams’ Santa Cruz apartment, four brightly colored birds sit on their perches in a large cage.  These birds are her constant companions, even when she goes out, which she doesn’t like to do very much.  “I don’t want to be out in public.  I feel uncomfortable talking to you because I know I have a mouth full of really bad teeth.  So it’s hard,” said Sams.  Her teeth actually look great.  “Well you should be here in the morning when I take a tube of goop and stick them all in.  I just literally got pieces stuck in that I put in in the morning.  And yesterday my bridge broke in pieces so I spent the whole day with a tube of crazy glue repairing it again,” said Sams.  She has struggled with her teeth for decades. Her employers never offered dental insurance.  Now that she’s retired, she’s living primarily on social security, and relies on Medi-Cal, which hasn’t offered much in terms of dental care since the program was slashed in 2009. 

But that’s about to change. The new state budget partially restores Medi-Cal’s adult dental benefits. They’re expected to include preventative care, like cleanings, filings and crowns, and full dentures.  “We’re just thrilled that we’ve got this benefit package back,” said Dr. Lindsey Robinson, President of the California Dental Association. The dental benefits will return next May and June.  Then state legislators have promised to continue the program into the next budget year.  In the meantime, Dr. Robinson says there’s work to be done.  “Well there will be a bit of a challenge in restoring the provider network. When the dental benefits for adults was cut out of the budget in 2009, the provider network disappeared. And so restoration of the network is going to take some time,” said Robinson.

The non-profit Dientes Community Dental Care in Santa Cruz is one of the few offices in Santa Cruz County that accepts Medi-Cal.  Executive Director Laura Marcus says there’s a three month wait to get an appointment.  “The number of people on Medi-Cal in our county has reached almost 50,000, which is like 1 in 5 people.   And there’s only seven offices in our county that accept Medi-Cal.  So if you can imagine the seven of us trying to meet that need. You know I think we’re meeting less than half,” said Marcus.  Dientes will soon break ground on a multi-million-dollar expansion that will allow the clinic to increase its patient load by 50%.    But reaching more Medi-Cal patients is about more than just space. Marcus says a better reimbursement rate would help get other dentists in the community to be part of the network.  According to the California Health Care Foundation, Medi-Cal dental reimbursement rates are among the lowest in the nation.  “It’s simply not affordable.  I think what’s fair, what’s fair is to pay more along the lines of private insurers,” said Marcus. 

Gloria Sams has experienced the effect of that low reimbursement rate. She had a difficult time finding a dentist who would take Medi-Cal until she found Dientes.  Now she anxiously awaits the reinstatement of dental benefits and hopes she can get an appointment to find out what can be done to help her teeth.  “May is too far way.  They need to do that now,” said Sams.