Michigan woman dies after Medicaid dental care is cut

By Hiram Lee
4 November 2009

An elderly Michigan woman died in October as the result of a severe dental infection after adult dental Medicaid benefits were cut in the state. Blanche D. LaVire, 76, had been diagnosed with abscesses earlier in the year and reportedly suffered from advanced periodontitis.

Because LaVire was mentally challenged, she required special treatment. Her condition was such that her doctors felt it would be unwise to undergo treatment in a dentist’s office. Advised to have the necessary procedure performed in a hospital, LaVire was then scheduled for an oral surgery near the end of June. The procedure was delayed when LaVire contracted pneumonia.

Once she had recovered from the pneumonia, doctors attempted to reschedule LaVire’s procedure, but discovered she was no longer covered by Medicaid. An executive order issued by Michigan’s Democratic Governor Jennifer Granholm had taken effect on July 1 that dramatically cut adult dental Medicaid benefits. All oral health services were eliminated by the order, with the exception of emergency services.

Doctors began the filing procedure to prove that LaVire’s case was indeed an emergency, but her infection was growing worse. With LaVire left unable to afford care, dentists with Michigan’s Dental Clinics North volunteered to treat her for free, but Medicaid would not pay the $5,000 hospital fees. LaVire then had no choice but to wait, hoping to be approved for emergency dental coverage. She died, still waiting, on October 7. Gerald Case, health officer with the Health Department of Northwest Michigan, spoke bluntly on the horror of the situation, saying, “Frankly, by the time the documentation was put together, she died.”

LaVire’s tragic and unnecessary death has drawn protests from medical professionals who oppose the reactionary cuts put into place by Granholm. Dr. Tom Veryser, the executive director of Michigan Community Dental Clinics, said of the cuts in dental care, “The developmentally disabled population, who require hospitalization to receive care, are left without access to needed dental services.” Of LaVire’s death, Veryser added, “We predicted cuts to the adult dental Medicaid benefit would cost lives and now it has.”

The Michigan Dental Association released a statement after LaVire’s death saying, “We join Michigan citizens in expressing our sincere condolences to this woman’s family. But at the same time, we recognize that the situation demands much more than condolences: The state must restore adult dental Medicaid benefits.”

Governor Granholm is currently the subject of a class action lawsuit brought on behalf of 400,000 citizens whose dental coverage was eliminated by her cuts to Medicaid. Granholm cut the adult dental benefits as part of an assault on social programs meant to address a $2 billion state budget shortfall. Along with eliminating dental coverage for hundreds of thousands with her Medicaid cuts, Granholm also cut $62 million in funds for state mental health services, $5 million in funds to hospitals for the treatment of the uninsured and approximately $100 million altogether in aid to cities and towns.

The situation is far from unique to Michigan. The economic crisis has left states facing record-breaking budgetary shortfalls and declining tax revenues. The universal response, by Democratic and Republican state legislators alike, has been to slash the most vital social programs. Health care, education and welfare have all gone to the chopping block. The poor and working class are forced to shoulder the burden of the crisis.

Dental coverage under Medicaid often has been reduced or eliminated entirely. While dental coverage for children is mandatory, adult dental coverage is optional under Medicaid, and states are not required to provide it. With state governments eager to eliminate the cost of this “optional” service, society’s most vulnerable, like Blanche D. LaVire, are left open to life-threatening infection, prolonged and severe pain, or other significant health problems, such as heart disease, to which poor oral health can be a contributing factor.