Empower Wisconsin | Oct. 25, 2019
By Cori Petersen, Wisconsin Institute for Law & Liberty
An ounce of prevention is worth a pound of cure. So why won’t state legislators pass a bill to expand lower cost preventative dental care in Wisconsin?
Wisconsin ranks among the top ten states for health care quality but is dead last when it comes to providing preventative dental care to the 550,000 children enrolled in the Medicaid program, according to a report from the Centers for Medicare and Medicaid Services. One taxpayer-friendly way to increase access to affordable care is by licensing dental therapists. A bi-partisan bill to do just that is currently stalled in both houses of the legislature. The bill, authored by Sen. David Craig (R-Town of Vernon) and Rep. Mary Felzkowski (R-Irma), would allow the free market to bring lower priced care to those who need it and deliver a major win for conservatives in divided government.
Licensed dental therapists would be allowed to perform routine dental procedures, such as fluoride application, tooth extraction, and cavity repair, all under the supervision of a dentist. And dental therapists are able to offer care at a lower price as midlevel care providers, somewhere between a dental hygienist and a dentist.
A big reason Wisconsin doesn’t provide enough access to preventative dental care is that there just aren’t enough dentists in rural areas of the state. According to the Badger Institute, in 2017, 1.5 million people, more than a quarter of Wisconsin’s population, lived in areas designated by the federal government as experiencing a shortage of dental care providers. Licensing dental therapists would increase access to care because even though dental therapists practice under the supervision of a dentist, they are not required to be in the same physical location, allowing them to travel to remote areas of the state, where the demand for routine care is high.
Wisconsin would not be the first state to license dental therapists. Several states, including our neighbors in Michigan and Minnesota, have increased access to lower cost dental care with dental therapists. Alaska, Arizona, New Mexico, Idaho, Maine, Vermont, Oregon and Washington, all states that have a large rural population, have also utilized dental therapists to make their health care dollars go further.
A 2018 case study conducted by Apple Tree Dental in southcentral Minnesota and funded by Pew Research, found the presence of a dental therapist allowed patients to experience shorter wait times and helped dentists triage their patient’s urgent care needs. Dentists also said that adding a dental therapist to their practice freed them from providing routine care so they could better focus on providing more complex dental services. Over the study’s three-year course, the dental therapist’s average daily billing was 94 percent that of the dentist’s, and because dental therapists are paid up to 50 percent less than a dentist, this was an efficient way for the clinic to expand its services at a lower cost. That’s why many have suggested that dental therapists could be the answer to the problem of low Medicaid reimbursement rates.
A bill to license dental therapists was proposed twice before in Wisconsin. In 2018 a dental therapy bill was drafted and circulated but never made it out of committee due to opposition from the Wisconsin Dental Association. Gov. Tony Evers included a plan to license dental therapists in his 2019-21 biennial budget. That plan also provided a Medicaid reimbursement increase for dental care, but it was stripped from the budget at the dental association’s request.
Now the dental association is arguing about the training of dental therapists, claiming therapists should not be allowed to perform nonsurgical tooth extractions.
Conservative lawmakers would do well to put the dental association’s agenda aside and see this bill for what it is: a free market solution to expanding affordable care while saving taxpayers money.
Cori Petersen is a writer and research associate for the Wisconsin Institute for Law & Liberty.