Dr. Ashley Huber of Siouxland Community Health Center in Sioux City says she sees a widespread shortage of Iowa dentists who treat Medicaid patients, especially on the western side of the state.
“The number one complaint I've seen and heard from dentists is Medicaid's current reimbursement rate is so low, it doesn't even cover the cost of overhead,” she said. “In order to take a Medicaid member on as a comprehensive patient, it actually costs them money to do that. So, it’s hard for a small business owner to be able to make that sacrifice.”
Currently, 78% of dental patients at Siouxland Community Health Center are Medicaid members. They accounted for 18,000 dental visits in 2022.
“Our patients, statistically, have twice as much disease as private practice patients. Historically, that's what we see, so our treatment plans are longer. They're more complex. It takes a lot more work to get someone stable.”
For the past 18 months, Huber’s clinic, with its five full-time dentists, started restricting new patients to children. She says it’s hard when they have to turn people away.
“It’s just the sheer number game. There are not enough hands here to treat everyone comprehensively. We have patients that come up to our front desk in tears, and they're like, 'I just, I can't, I can't do it, I can't take it anymore.'”
Huber says in many cases, patients who need emergency care end up seeking service elsewhere.
“It becomes an issue where a patient gets so infected that they end up in the ER, and they end up with this giant hospital bill. Or the state ends up with a giant hospital bill. There isn't a lot we can do unless we get more providers.”
As more people use hospitals for dental issues, Huber says the issue will likely receive more attention from professional associations and lawmakers who can facilitate real change.
Huber believes a strategically structured increase in reimbursement rates for Iowa Medicaid would be one solution to draw dentists back into the provider pool.
She also sees a need for more dental assistants.
“Without assistants, we can’t hire more dentists — and without dentists, we can’t grow our patient base.”
The Associated Press reports that six states started or expanded their Medicaid programs this year to provide coverage for adults. Medicaid requires states to provide dental coverage for children, but not adults.
“Without assistants, we can’t hire more dentists — and without dentists, we can’t grow our patient base.”Ashley Huber, dental director of Siouxland Community Health Center
The Iowa Dental Association tells IPR News they do hear concerns about the dental Medicaid program from dentists and they acknowledge a problem throughout Iowa. Executive Director Laurie Traetow says Iowa dentists care about their communities and strive to provide care to everyone, regardless of their socioeconomic status. She adds dental Medicaid rates have been stagnant for more than 20 years, making it difficult for patients and dentists.
Traetow says the Iowa Dental Foundation started the Iowa Mission of Mercy, a free, two-day dental clinic held in a different city each year. This year’s event takes place in Waterloo, Oct. 13 - 14, and will return to Sioux City next year.
