Blog post by Manar Hussein, Health Care Access Intern + Freedom Thompson, Health Care Access Community Organizer
In the heartland of America, a silent crisis is unfolding. Nebraskans from all walks of life are struggling to access essential oral health care, facing a complex web of challenges that stretch far beyond simple toothaches. Through the stories of our neighbors, we uncover a system fraught with gaps, where the promise of care often falls short of reality.
Meet Sierra, a mother of three whose journey through the maze of oral health care is all too familiar. “At 19, my provider refused services and said they stopped taking Medicaid. I had to wait 10 years for oral care,” she recounts. Now, even with employer insurance, Sierra faces a $5,000 out-of-pocket expense for necessary treatment. Her story illuminates the precarious transition many face between Medicaid and private insurance, a gap that often leads to years of neglected care.
This financial tightrope walk is one Brandon knows well. Recently informed that he “made too much” for Medicaid, he now grapples with an impossible choice. “Rental utilities come first,” he explains, highlighting the cruel irony of a system where earning more can mean losing access to essential health services.
Even for those who maintain Medicaid coverage, the challenges persist. Susan, a foster parent, paints a picture of scarcity and frustration. “I waited months to get in with the one provider at the time taking Medicaid, only to have the appointment canceled without notice on the day of.” In some areas of Nebraska, adults on Medicaid face years-long waitlists for a single provider, turning routine care into a test of endurance.
Perhaps most troubling are the undercurrents of discrimination that ripple through these experiences. Susan noticed “contrasting different treatment, looks, and recognizes implicit bias based on race, status as a foster child, and socio-economic status as a Medicaid recipient” when comparing the standard of care received between her white biological son and her mixed Indigenous foster daughter. These disparities add an emotional weight to the already heavy burden of seeking care.
Moreover, the link between oral health and broader health outcomes cannot be overstated. From heart disease to prenatal care, the mouth is a gateway to overall health. By neglecting oral care, we risk a cascade of health issues that could be prevented with timely intervention.
The path forward requires a multifaceted approach. Implementing policies to recruit more providers (especially in rural areas), improving cultural competency training, and enhancing communication about coverage and benefits are just the beginning. See our recent brief “Oral Health is Key to Overall Health: Improving Dental Coverage in Nebraska Medicaid.”
As we push for these changes, we must remember the human stories behind the statistics. Each canceled appointment, each delayed treatment, and each choice between rent and dental care represents a Nebraskan in need. By listening to these voices and taking action, we can create a system that truly serves all Nebraskans, ensuring that quality oral health care is not a luxury but a fundamental right accessible to all.
The road ahead may be long, but with each step, we move closer to a Nebraska, where a healthy smile is within everyone’s reach. Together, we can bridge the gaps in our oral health care system, creating a stronger, healthier future for all.