Thursday, March 12, 2015

Issues with Affordable Care Act, Part 1

I thought my next blog should be in 2 parts because of the complexity of the topic and my attempt to keep the blogs relatively short, so people will actually read them.  The topic we will be discussing today is the status of dentistry in California and how it is affected by the Affordable Care Act or Covered California.  Unlike Hilary Care in 1994 the ACA specifically left out dentistry to a large extent.  So why do I need to discuss it in a dental blog?  Well, while there is no federal dental funding mandate for the ACA, it does have a requirement for children’s dental healthcare coverage up to the age of 19 (no, not 18 or 26) for all insurance companies participating in the exchanges, including Covered California.  Obviously, from appearance that is certainly not a problem for California dentists and all Californians up to 19, who now will be covered by insurance.  After all that certainly boosts the demand for dental services and that is good for dentists and good for the patients that will benefit from our services with better oral health.  That certainly sounds like a win-win but unfortunately that is not the case.  The hidden problem is that Covered California in the ACA wants to increase patient care by subsidizing the cost of that increased patient access by putting millions of children into a single payer program paid for by the government.  In California, that huge figure translates to 5.1 million in 19 year olds and younger patients on Denti-Cal (the California version of dental Medicaid or Welfare).  Well what is the problem with that?  Let’s put it into perspective.  California is the 8th largest economy in the world with a gross state production (GSP) of approximately 2.05 trillion dollars or 13.2% of the federal gross national product (GNP).  We currently have an unemployment rate of 7.4%, the fifth highest in the nation, which is certainly nothing to be proud of (but it is getting better).  The states demographics in the current census is 30.1% 19 year olds and younger of our total population of 37 million.  That means we have a total of 11,100,000 19 year olds and younger.  That translates to 46% of child population on welfare. Is that a problem?  Only you can decide, but it is certainly concerning to me that if we are such a great state, why almost half of our children on Welfare?

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