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Smiles Across Montana faces service challenges in the face of Medicaid cuts

As DPHHS rolls out eligibility determinations post-COVID, many are being dropped from coverage unexpectedly.
Posted at 3:51 PM, Feb 07, 2024

BOZEMAN — Smiles Across Montana has been providing dental services to under-served communities for more than seven years—but recent cuts in Medicaid have caused the nonprofit to face serious challenges.

"We go through the entire state of Montana bringing dental services, preventative services, and minimal restorative services to areas of low access to care," says Executive Director Crystal Spring.

Spring says the team covers five tribal nations in Montana and visits rural areas with their mobile unit, where services are most needed.

"Last year, 2023, was our biggest year. We served over 6,000 patients last year. Any given day we can have three to four clinics happening at the same time in different areas," says Spring.

Smiles relies heavily on Medicaid insurance. But as many people fall off of coverage due to the post-COVID re-determination process, the nonprofit is struggling to meet patient needs.

Spring says, "I feel like the carpet was kind of pulled out from underneath us. And I know that across the state a lot of dental offices are experiencing the same thing."

Officials at DPHHS explain that the re-determination process is a standard annual event, but COVID postponed eligibility determination for nearly three years, catching many off guard once they were dropped.

Jon Ebelt, DPHHS Director of Communications says, "This process has meant ensuring the most vulnerable have access to the resources they need while also protecting taxpayer resources from intentional or unintentional program abuse.”

DPHHS also says residents may still be eligible to receive medical benefits. And despite barriers to applying, Smiles hopes it can get the word out to patients who lost care.

"You know, what’s at stake is first, we’ll have to stop going to some of the areas where it’s just too expensive to travel to. We’ve had to create a waiting list now for a lot of our uninsured and that’s been hard on a lot of our providers," Spring says.

Smiles offers a scholarship program for uninsured patients and with community support may be able to turn things around.

"We’re partnering with a lot of different groups to just bring awareness around it and to get kids signed back up."

Visit the Smiles Across America website to learn more.