Medicaid state waivers and their impact on children’s dental coverage (2006)

With Medicaid continuing to dominate governors’ agendas, many are looking to the federal government for options to contain state costs by significantly altering the basic structure of children’s coverage. Medicaid waivers, particularly “1115 waivers,” have become a primary method for some states to contain Medicaid expenditures. While these waivers were once a strategy for expanding Medicaid coverage, they have now become a battleground for maintaining fundamental pediatric services.

In response to governors’ efforts, Congress recently passed Medicaid provisions in the Deficit Reduction Act of 2005 that include new options previously only available through state waivers. Additionally, President Bush has called for further waiver expansions. Both hold potential to threaten dental coverage for children by allowing states to limit services currently required by Medicaid’s EPSDT benefit.