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Abstract #162902

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Meg Booth and Burton L. Edelstein, DDS, MPH. Children's Dental Health Project, 1990 M Street NW, Suite 200, Washington, DC 20036, 202 833 8288, mbooth@cdhp.org

Since the enactment of SCHIP 10 years ago, the US Congress and Federal regulators at the Centers for Medicare and Medicaid Services have steadily moved publicly financed health coverage in new directions. These directions reflect both (1) increased state autonomy and flexibility and (2) increased emulation of commercial insurance standards. While these directions closely emulate secular medical - rather than dental - coverage trends, they have a profound impact on the delivery of dental services to low income populations. We examine how this progression of recent legislation and regulation modify assumptions first codified in the 1967 Medicaid Early and Periodic Screening Diagnosis and Treatment (EPSDT)program. Specifically, we consider how (1) the original enactment of State Child Health Insurance Program (SCHIP), (2) the Health Insurance Flexibility and Accountability waiver program (HIFA), (3) the Deficit Reduction Act (DRA), and (4) the reauthorization of SCHIP together constitute a continuum of policy change that reflects increasing federalism and commercialism. We consider how these initiatives create potential for both negative impact on services and new opportunities for experimentation as the role of government-sponsored dental coverage for vulnerable children continues to evolve.

Learning Objectives:

• Describe temporal trends in Congressional action on dental access issues
• Understand the impact of federalism and commercialism on dental access legislation
• List major legislative efforts that impact dental access

Keywords: Oral Health, Public Policy

Related Web page: www.cdhp.org

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

• Slides (pdf) or Handout