State influences include state departments of Health and Human Services. State Health Departments include Dental Divisions whose directors work as dental consultants within the state. These departments may work to implement water fluoridation within communities and initiatives such as oral health promotion and disease prevention, for those who are underserved.
The Human Services Division of the State Health Department usually is responsible for the Medicaid program, which is often operated by a third party (insurance agency). Medicaid is the public program that funds dental care to the low-income population and is administered by states, but is also funded partially by the federal government via tax dollars. Because of the states’ freedom to apply the federal money in various ways, Medicaid dental coverage differs from state-to-state, although all states must provide comprehensive dental care coverage to children.
Another program, Children’s Health Insurance Program (CHIP) provides federal matching funds to states to provide health coverage (including comprehensive dental coverage) to children in families with incomes too high to qualify for Medicaid. This program aims to ensure no children are uninsured in regards to health coverage.20
Medicare primarily funds medical care, not dental care, for people who are 65 years or older and/or in some instances people who have disabilities. In specific cases, Medicare may provide reimbursement for dental procedures, such as a tooth extraction, provided in the hospital on those over 65 or individuals who have disabilities, but it generally does not fund dental care.20
States generally assume care for inmates of state prisons. Additionally, states provide funding in some instances for those with disabilities. States and local governments work with federal agencies to provide care in tribal dental clinics, migrant health clinics and in some instances in schools, and head start programs.