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Medicaid's ‘Optional Services’ A Poor Choice For Cuts

As Florida lawmakers search for ways to balance the state’s budget in the fact of an estimated $3.62-billion shortfall, AARP Florida and others are warning lawmakers away from one idea: Cutting certain Medicaid-funded services for older Floridians, such as dentures, hearing aids, eyeglasses and hospice care.

While no detailed plans for such reductions have been publicized yet, some advocates for older people are concerned that legislators may consider reductions to these services – called “optional services” because the federal government doesn’t require states to offer them – in an attempt to cope with Florida’s budget woes.

"These services may be called 'optional’, but this is a case of a cut that could cost more than it saves – much more," said Jeff Johnson, interim state director for AARP Florida. "To cut these optional services would be penny-wise but pound-foolish because, in many cases, these services enable older Floridians to stay healthy and live independently."

For instance, many Medicaid patients who receive dental services may have increased difficulty eating if they’re not able to get dentures and other care through Medicaid, a federal and state insurance program for U.S. citizens of modest means.

"When frail older Floridians can't get dental care, their health suffers in many ways," added Johnson. "And that leads to much higher costs for hospital, nursing home and assisted living care.”

The American Dental Association says that mid-range dentures cost between $500 to $1,000 per plate. By comparison, nursing home costs in Florida range from $65,000 to $70,000 per year, while hospitalization costs could be several times those figures.

The good news, Johnson says, is that Florida legislators have recognized this issue and found ways to preserve such services. In 2008, Florida legislators briefly considered, then discarded, plans to eliminate Medicaid coverage for dental care for an estimated 146,000 older Floridians. Instead, other ways were found to keep the program intact.

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