Annual Economic Report from UK business school examines impact of health-care reform, state of oral health in Kentucky

The federal health-reform law could have a big impact on Kentucky's uninsured population, and Kentuckians' oral health is improving but still at risk. Those are two major health findings in the 39th Annual Economic Report from the Center for Business and Economic Research in the University of Kentucky's Gatton College of Business and Economics. Kentucky's poor health status, relative to the rest of the nation, can be an economic handicap.

Health care reform

The report notes that health reform could benefit 626,000 uninsured Kentucky residents, 15 percent of the state's total population. Implementation of the new law will mean:

• 920,000 health plans will be prohibited from denying coverage to persons with pre-existing health conditions.

• 261,000 people will benefit from expanded Medicaid eligibility. In 2014, Medicaid eligibility will expand to cover all citizens and legal immigrants under 65 who earn up to 133 percent of the federal poverty level‚ $14,404 for an individual and $29,327 for a family of four in 2009.

• 51,500 small businesses will receive tax credits to purchase coverage for employees.

• 221,000 families will receive tax credits to purchase health insurance.

However, the study noted that implementation of the health care law is still precarious. "The increased coverage promised by the new federal law will both provide and require new resources. Federal-state relationships will be tested ... Court challenges to major provisions of the law create even more uncertainty over the future contours of Kentucky's uninsured population," researcher Debra Miller wrote.

Oral health

Between 1996 and 2008, oral health among Kentucky adults generally improved, according to most indicators. "We find an across-the-board improvement for virtually all social, economic, and demographic groups for being at risk for permanent tooth extraction, but the likelihood of visiting the dentist decreased for many between 1996 and 2008," researchers Michael Childress and Michal Smith-Mello write. The percentage of Kentuckians missing six or more teeth declined from 32 to 22 percent, and the percentage at risk for permanent tooth extraction decreased from 63 to 51 percent.

But the researchers said the positive trends in Kentucky's health might not continue, noting challenges such as "changes in the health insurance market, high rates of smoking, rising obesity rates, and persistently poor oral health coupled with shortages of dentists in some regions in the state."

The researchers noted that the American Dental Association projects a 12 percent decline in the dentist-to-population ratio from 2001 to 2015. A 2006 Kentucky dental provider workforce analysis estimated the state would lose 286 practicing dentists by 2016. That has already started to happen, with Appalachia — 30 percent of whose residents already have six or more teeth missing — losing 15 dentists from 2006 to 2010.

Researchers say getting more dentists to participate in the Medicaid program, public health campaigns aimed at dental and medical providers, outreach programs and coming up with creative incentives such as forgiving loans to dentists who agree to work in underserved areas would help progress move forward.

The report, which looks at various aspects of Kentucky's economy, also examined when Kentuckians should expect the economy to recover; poverty rates; educational achievement gaps; and access to technology, including broadband access. For a summary click here.