Come July 1, 65,000 parents, senior citizens and blind and disabled Utahns will lose their dental benefits. About 40,000 will lose their vision coverage.
The $5 million in legislator-ordered cuts come even as $70 million of a record surplus sits in limbo. The surplus was supposed to be returned to taxpayers as part of Utah's move to a flatter income tax - and remains earmarked for that purpose. Gov. Jon Huntsman Jr. is asking lawmakers to resume the tax reform debate at a special session before the end of May.
Medicaid reform will have to wait.
A proposed Medicaid task force got hung up in a logjam of bills. Also, proposals for restoring dental and vision coverage will not be taken up at the special session, Huntsman's spokesman, Mike Mower, said Tuesday.
The news comes as a blow to Lisa Parker, a single mother of three on Medicaid who is tired of seeing her dental benefits stripped, restored and stripped again. The last time lawmakers slashed dental care was in 2002-2003.
The benefits were reinstated last summer, too late to spare Parker from four root canals. Without dental coverage, Parker won't be able to afford to keep up with cleanings and exams. She will have access only to emergency care, such as teeth extractions and treatment for infections.
"My teeth are in good shape now, but for how long? It's like I'm at ground zero again. Bad teeth run in my family," said the Taylorsville woman, who is in school to become a nurse. "Those prospects are dimming. No one wants a nurse with a toothless grin."
Parker hopes to see a dentist before the July cutoff. But that may prove difficult, even for pregnant women and children who will keep their benefits.
Dentists say the low reimbursement rate that Medicaid pays is hurting business. Paul Macklay, who runs an association of five dental offices along the Wasatch Front, is considering dropping Medicaid patients - 65 percent of his clientele.
"Our practice is in the red. We don't want to sever the relationship with patients, but we can't keep subsidizing their dental care," Macklay said. "I understand we're not trying to promote a welfare state. I wear two hats; one as a taxpayer and one as a dental provider. But the system we have now is broken and in real need of reform."
One idea that failed to gain traction, but that low-income advocates are committed to reviving, is to move to a managed-care model. Networks of optometrists and dentists would contract with the state to provide basic dental and vision care for much less than the state pays now.
Reform will be complicated because Medicaid is more than government-funded health insurance. For years, Utah has built its foster care, aging, substance abuse, mental health and other public welfare programs around the federal funding.
Federal cutbacks this year forced lawmakers to restore $30 million in lost Medicaid dollars to the state's foster care system.
They did so at the expense of vision and dental, and with one-time money, which means state Human Services Director Lisa-Michele Church will have to renew her funding pitch next year.
Republican leaders have asked Church to review her entire array of Medicaid-funded programs with an eye toward preserving the most critical.
''I welcome that type of scrutiny, because our programs do provide a valuable service to the community,'' Church said. ''It's important to develop criteria, and not just say, 'This year the feds are cutting mental health, so we'll cut mental health.' "
kstewart@sltrib.com
