Dental care is the most common health service pushed out of reach for adults, with deep disparities across race and among people with low incomes. But there is good news: more adults struggling to make ends meet may soon have greater access to dental coverage. In several states, lawmakers are working across the aisle to expand these benefits for adults enrolled in Medicaid. 

Opening the door to dental care for more people can usher in better health and family economic security – gains worth celebrating! But state policy can only go so far. Congress must also take action. 

At the federal level, children enrolled in Medicaid and the Children’s Health Insurance Program can count on dental benefits nationwide. But similar coverage for adults is optional for states to provide, leading to an incredibly uneven landscape of coverage nationwide. It’s time for Congress to ensure our oral health doesn’t depend on where we live. Federal lawmakers can require Medicaid to cover comprehensive dental services for all adults and also support other approaches, like dental therapy, that improve access.  

States advance better dental coverage with broad support 

Since 2021, policymakers in four states passed bipartisan measures to expand adult dental coverage in Medicaid. We applaud the lawmakers and our state partners, including Oral Health Kansas; Maryland Dental Action Coalition; Tennessee Justice Center; Maine Equal Justice; and Maine Oral Health Coalition, who championed these steps toward health justice: 

  • In Maine, policymakers expanded comprehensive dental coverage in 2021 that will help over 200,000 people enrolled in the state Medicaid program. These benefits will start in July. 

  • In Kansas, a new law that took effect in April will greatly expand the adult dental benefits covered by the state’s Medicaid program. Now, policymakers must define what new benefits will be provided, beyond current emergency care. This law will bring coverage to over 150,000 people when it takes effect later this year. 

  • In Maryland, also in April, the Legislature passed a measure to cover comprehensive dental care for adults enrolled in Medicaid. As of this writing, it’s still waiting to be signed in to law by the governor. The bill would extend comprehensive dental coverage to adults in addition to former foster youth and pregnant people through one year after giving birth. If it becomes law, adult dental coverage will start in January 2023. 

  • In Tennessee, legislators improved Medicaid coverage for pregnant people over 21 in more ways than one. Previously, pregnant and postpartum Tennesseans could only use the Medicaid program for 60 days. And it didn’t cover oral health care. Policymakers have extended Medicaid coverage to one year after birth and added dental benefits. These changes took effect in April. 

In other statehouses, bills boosting Medicaid dental coverage for adults continue building momentum: 

  • In New Hampshire, lawmakers are advancing a broadly supported bill to help 100,000 adults enrolled in Medicaid gain more comprehensive dental coverage. Currently, the state’s Medicaid program only covers emergency dental care.  

  • In Hawaii, there is also widespread support to restore comprehensive oral health benefits that were cut from its Medicaid program during the 2008-2009 recession. State policymakers may use a current budget surplus to deliver these benefits to over 200,000 adults enrolled in Medicaid. 

These policies would help address longstanding inequities in access to oral health care while improving people’s overall health and that of their families. Better oral health has shown to strengthen economic mobility and job opportunities, helping workers and communities thrive. 

Our research has also proven that expanding Medicaid dental coverage for adults can yield significant savings. For example, it can save the health system nearly $2 billion annually in emergency department visits for dental pain and lower states’ overall spending on dental care. 

Congress must guarantee dental coverage all year, at every age, in every state 

Maryland and Tennessee lawmakers rightly recognized that good oral health can support healthy pregnancies. When left untreated, oral disease can lead to dangerous pregnancy complications. People most hurt by barriers to pregnancy-related care and to dental care are Black, Latino and other people of color; people with disabilities; and those in rural and tribal communities, and people with low incomes. Last fall, we highlighted how oral health care access is critical to reproductive and birth equity. With partners across the country, we continue to urge Congress to ensure dental coverage for pregnant and postpartum people. 

Hawaii policymakers’ efforts to restore previously gutted dental benefits speaks to another reason for Congress to act. As long as dental coverage is optional for state Medicaid programs to provide, it will be at risk when state budgets are tight. 

Our access to health care, including dental services, shouldn’t depend on where we live, our age or income. Federal policymakers can advance the Medicaid Dental Benefit Act, which would make oral health coverage a mandatory benefit for all adults in Medicaid. At the same time, coverage is only part of the solution to ensure access to care. Lawmakers can also strengthen the oral health workforce by supporting dental therapists. Boosting the number of providers trained to deliver dental care to communities most in need goes hand in hand with improving coverage. 

Congress should follow the lead of states investing in oral health equity. Millions of adults count on Medicaid for their health care. It’s time our leaders ensure that it includes dental care.