The Role of Physicians in Children’s Oral Health
Dental disease is the most common chronic disease among children in the United States. Although Medicaid entitles children to medically necessary dental care under the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit, many children do not see a dentist until age 3 or later – even though cavity risk factors can be well established before a child’s first birthday and before the first tooth erupts. Untreated dental disease can lead to dietary problems, infection, missed school days, and a lower quality of life.
Presumptive Eligibility for Pregnant Women
Early prenatal care plays a critical role in the health of pregnant women and their babies. Access to early prenatal care can lead to better birth outcomes, healthier babies, and reduced health care costs. Presumptive eligibility in Medicaid has become an important strategy for improving access to prenatal care for low-income pregnant women.
Medicaid 1115 Family Planning Demonstration Waiver Programs
Twenty-seven states have received Medicaid 1115 demonstration waivers to provide family planning services to individuals not otherwise eligible for Medicaid or the State Children’s Health Insurance Program (SCHIP). Two other states have applied for waivers. This updated State Health Policy Monitor examines the status of these waivers, and provides a brief overview of eligibility guidelines and benefits. Additional NASHP publications examine specific waiver design features, and explore topics such as cost savings and the impact on health outcomes.
Medicaid Coverage of Adult Dental Services
This State Health Policy Monitor presents the results of a 2008 survey of state Medicaid programs, which provides an update on the status of states' Medicaid coverage of adult dental services. As of early 2008, 45 states, including the District of Columbia, provided some type of coverage of dental benefits to at least some Medicaid-enrolled adults.
Premium Assistance
This State Health Policy Monitor discusses the use of premium assistance, a program in which federal and state Medicaid and/or SCHIP funds help pay for employer-based or other private health insurance coverage, often using employer or enrollee fees to help pay premium costs. The program is used both as a strategy to cover individuals already eligible for Medicaid and to expand health coverage to the uninsured.
SCHIP Delivery Systems
This State Health Policy Monitor provides an overview of the delivery systems and payment structures states use for their State Children’s Health Insurance Programs (SCHIP). States generally choose from among:
• Contractor-based managed care delivery,
• Primary care case management (PCCM), and
• Traditional fee-for-service arrangements.
SCHIP Dental Benefits
This State Health Policy Monitor examines the status of SCHIP dental benefits in the 39 states that have such benefits in their programs. The paper discusses the variations among states in covered services, cost sharing, and benefit caps.
