A class-action suit will bring about a transformative change for the 5 million adults in New York state who are on Medicaid: coverage of common but costly dental procedures, including implants, root canals and replacement dentures.
Blanca Coreas, who has a host of health problems related to her dental issues, in the Bronx, July 19, 2022.
The suit, filed in 2018 in federal court against the state Health Department, which oversees Medicaid in New York, charged the state with denying thousands of low-income New Yorkers medically necessary treatment. For decades, Garcia said, New York’s coverage rules for Medicaid were “structured to pull your teeth rather than save them.” And because one of the main jobs of a tooth is to hold its neighbors in place, an extraction often has a domino effect: Losing teeth leads to losing more teeth.“Once you start missing one tooth, the teeth start shifting,” said Victor Badner, chair of dentistry at Jacobi Medical Center, a city-run hospital in the Bronx borough of New York City.
The suit’s lead plaintiff, Frank Ciaramella, died in 2020. In 2018, his dentures were destroyed after he sneezed; they fell out and were run over by a car. Under the old limits, he was not eligible for new dentures until 2024. The settlement obligates New York Medicaid to cover implants, replacement dentures and most root canals if a dentist authorizes the procedures.
The gaps in Medicaid’s dental coverage also worsened racial health disparities. Garcia said that Black and brown adults suffer from untreated dental disease at nearly twice the rate as white adults.
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