In 2002, in order to save money, Idaho lawmakers eliminated adult dental care from the government medical welfare program called Medicaid. This sparked some amount of media-fueled outrage when an elderly woman supposedly claimed that the Department of Health and Welfare told her she could “gum her food” instead of getting dentures to replace her deteriorated bottom teeth.
I say “supposedly” because no one knows whether this story is actually true. It was a claim made by a candidate for office at the time; the media picked it up and ran with it. (More on that for paid subscribers below).
The actual woman in question — said to be 92 — was never identified and never stepped forward. The candidate for office lost his campaign. Whether the story was real or fabricated, it has framed the discussion about Medicaid adult dental services ever since.
Responding to that criticism, the Legislature brought the program back in 2003. And then cut the program in 2011. And brought it back in 2018. Now we’re in 2026, and Gov. Brad Little’s budget contemplates some unknown cuts to Medicaid. This has lawmakers discussing the fate of adult dental care yet again. This is largely because Little has submitted a budget that obliquely calls for cuts to Medicaid, but doesn’t specifically say where those will be applied. Adult dental services is one of the possibilities. Again.
And typically, the argument for keeping the program in place will go something like this: If the state doesn’t pay for dentures and teeth extractions now, we’ll pay for tooth aches and heart disease later.
This is the problem with government-run charity. It becomes an exercise based on accounting and optics. And because government has drowned out private charity, there are not a lot of alternatives left standing.
So a government program starts, stops, starts, and stops, and the people who depend on the services are left wanting. If government were not involved in the delivery of adult dental services to the poor, it is more likely that a non-government alternative, if the market demands it, would spring up in its place. But here, it’s the worst of all possible scenarios: Government drowns out charitable alternatives and then pulls the plug on the replacement from time to time.
The correct approach to the situation is to ask:
Does the government’s involvement in providing adult dental care stand in the way of compassionate, charitable alternatives? The answer is obviously yes. Since the answer is yes, the question shouldn’t be framed as “what program can we temporarily eliminate to balance the budget?” but rather “is our history here making access to care sporadic and unpredictable?” The answer is obviously yes.
