Bills supporting low-income children’s oral health move forward in the legislature

Two bills aimed at expanding and increasing access to the Access to Baby & Child Dentistry (ABCD) program are moving forward this legislative session.

The ABCD program, which recently celebrated its 20 year anniversary, connects Medicaid-enrolled children under six years old with preventative oral care. Through local ABCD programs, public and private partners work together to recruit and train dentists to provide care to eligible children, identify children and families for the program, and remove barriers that might prevent them from accessing care.


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As part of ABCD, the Health Care Authority (HCA) contracts with the University of Washington’s School of Dentistry and the Arcora Foundation, the foundation of Delta Dental of Washington, to provide training, develop curriculum, and certify providers to participate in the program. HCA then pays enhanced reimbursement fees for ABCD-certified providers who deliver program services. Arcora Foundation also funds and manages the statewide ABCD network of local programs and state partners and provides technical support.

While the ABCD program has drastically increased the percent of low-income children in Washington who have seen a dentist, gaps in coverage still exist — especially for children of color.

According to Arcora Foundation, “By third grade, 75% of Pacific Islander children, 71% of Latino children, and 68% of American Indian/Alaska Native children have tooth decay, compared to 46% of white children.”

Similar disparities exist for children who speak a language other than English.

Arcora Foundation also notes that in FY 2017, only 33% of Apple Health-insured children 0-2 years old received a dental visit. This can result in negative health impacts down the road as early preventative dental care is associated with fewer needed treatments and lower costs later in life. This is why experts recommend that every child have an oral health screening by a dentist or physician by age one.

One bill working its way through the legislature aims to address these disparities. HB 2905 directs the HCA to develop a local ABCD program fund allocation formula, key deliverables, and target metrics for increased provider engagement and outreach. The bill directs the HCA to monitor progress made toward increasing the percentage of children under age 2 receiving care, and reducing the racial and ethnic disparities in access to care.

“We want to make sure that we’re increasing access to the ABCD child dental program and making sure that we’re also reaching out in an equitable way, and that’s what this bill does,” said Rep. June Robinson during the bill’s executive session in the Appropriations committee.

HB 2905 passed off the House floor unanimously on February 16 and is scheduled for executive session in the Senate Health & Long Term Care Committee on Friday.

The other bill, SB 5976, looks to expand ABCD program eligibility to children with disabilities up to age 13. In 2018, the legislature passed a bill that would expand eligibility to this population, but the HCA experienced difficulty obtaining CMS approval based on the language included in the original legislation, according to Senate Ways & Means Committee staff. SB 5976 makes changes to the language related to eligibility in order to obtain approval.

During the bill’s public hearing in the Ways & Means Committee, Emily Lovell, Director of Government Affairs at the Washington State Dental Association, spoke in favor of the bill.

“By expanding the ABCD program to include children with disabilities through age 12, we will be ensuring that some of our state’s most vulnerable populations will be provided with comprehensive dental benefits, a dental home, and a better chance of maintaining a lifetime of good oral health,” said Lovell.

SB 5976 passed out of the Senate on February 12 and was referred to the House Appropriations Committee last Friday.