There is an Increasing Trend Toward Increased Dental Coverage for Medicaid Patients Across the United States

There is a growing trend across the United States for states to expand dental benefits associated with Medicaid. Medicaid, the federal and state health insurance program designed to aid the economically disadvantaged, typically covers children but many adults have very limited access to dental care. However, as awareness of the economic and health repercussions of poor dental health grows, and given infusion of federal pandemic funding, seven states have expanded or initiated Medicaid programs this year to include dental coverage for adults. Nevertheless, access to dental care remains problematic in several of these states, as numerous dentists refuse to treat Medicaid patients. The consequences of neglecting dental care can be substantial, leading to increased costs for taxpayers and hardships for individuals who cannot afford treatment. According to a study by the American Medical Association, poor dental care leads to 1.8% of all emergency room visits and over $2.4 billion in associated costs. Additionally, lack of access to dental care can lead to significant losses in productivity.
Almost all states do provide some level of Medicaid dental benefits for adults, but restrictions often limit coverage to specific population segments, such as pregnant women or individuals with intellectual disabilities, or may only encompass emergency care. Coverage is still limited in a number of states for Medicaid adults. One state Alabama offers no benefits. Four states offer only emergency coverage. And while the other 45 states have some benefits, often they only cover a small percentage of total costs. A handful of states cover less than 20% of total services but most cover 50% or more.
The most recent additions to Medicaid dental coverage include Hawaii, Tennessee, Kentucky, Michigan, Maryland, New York and New Hampshire. Hawaii expanded dental coverage to it’s adult population starting Jan. 1, 2023 after a ten year hiatus allocating over $25 million in additional funds. Tennessee expanded Medicaid dental coverage this year to 650,000 Medicaid recipients 21 and older spending an estimated $75 million. In Kentucky, Democratic Gov. Andy Beshear pushed forward coverage for 900,000 Medicaid adults using emergency regulations after the Republican-led legislature rejected his proposal. In Michigan Molina who manages the Medicaid program will expand coverage for adults over 21 starting April 1, 2023 representing an $85 million funding allocation. Starting Jan. 1, 2023 800,000 Maryland Medicaid enrollees got access to coverage after a bill passed the state legislature in December. In New York a settlement in a recent class action suit in May that the state was denying necessary dental care to vulnerable populations brought about coverage for five million Medicaid patients, including implants, root canals, and replacement dentures. In New Hampshire the state started coverage this year is spending $33 million to cover 88,000 Medcaid beneficiaries.
One additional challenge despite the progress is many dentists don’t accept Medicaid patients due to low reimbursement for major services. A study by the American Dental Association in 2015 found only 38% of the roughly 200,000 U.S. dentists take Medicaid patients. A 2021 ADA study found that in some states despite the majority of dentists being enrolled in Medicaid many often don’t see any patients. For instance, in Colorado, despite a program encouraging dentists to treat at least five Medicaid patients annually, nearly one-third of enrolled dentists did not see any Medicaid patients. This suggests that while efforts to boost provider enrollment have been somewhat successful, there are still challenges in ensuring that Medicaid patients can access healthcare services.
However, despite these challenges, expanded Medicaid coverage could lead to increases in demand for dental care. It is clearly a growing trend in the United States is the expansion of dental benefits within Medicaid, the federal and state health insurance program aimed at assisting economically disadvantaged individuals. Seven states have now taken steps to address this gap by expanding or initiating Medicaid programs in the current year to include dental coverage for adults. Neglecting dental care is increasingly understood to have far-reaching consequences, leading to increased costs for taxpayers and hardships for individuals who cannot afford treatment.