What Do the Changes in DC Mean for Oral Health Policy?

By Melissa Burroughs, Director, Public Policy, CareQuest Institute

For far too many people in America, good oral health is too expensive and out of reach. Too many families must make impossible trade-offs between getting the care they need and going into debt or putting food on the table. As we head into 2025, we need to ensure that policymakers understand the importance of oral health and its impact on our overall health and on our finances. 

When we look at major themes coming out of this last election, like cost of living and job opportunities, it’s clear that oral health is an important part of the equation. Oral health can impact everything from diabetes to heart disease to birth outcomes to Alzheimer’s. Poor oral health can lead to expensive health and dental care or even missed job opportunities. 

Now, more than ever, our nation needs policy changes that improve oral health — and we also need to ensure that the progress we have made is not put at risk. 

With a new Congress and administration, these are key action items to advance and protect strong oral health policy in 2025: 

Revitalizing Medicare and Medicaid Dental Coverage Efforts 
For decades, oral health advocates have worked to influence federal policy changes that would add comprehensive dental benefits in both Medicare and Medicaid. We’ve seen incremental gains and meaningful momentum, especially in the last few years. This year, however, many of the policymakers who have championed these issues either lost elections or retired. While we aren’t likely to pass legislation on these issues in the next few years, it will be important to build up new champions and refresh our long-term efforts.

Defending Against Medicaid Cuts 
As the new Congress and administration take office, they are considering cuts and changes to the Medicaid program to pay for tax cuts and other priorities. Many of these proposals would result in cuts to Medicaid dental benefits. Proposed policies include changing the way state Medicaid programs are financed — through block grants or per capita caps — which effectively force states to cut all optional services, including dental. The new administration is also likely to take direct actions to change Medicaid, including allowing states to implement certain program features such as work reporting requirements through Medicaid waivers, which can unnecessarily kick people off their insurance coverage or require them to “earn” their dental benefits. As these discussions progress, oral health advocates will be an important voice, alongside many other health stakeholders, in defending the Medicaid program from cuts. 

Strengthening Veteran Access to Dental Care 
Only some veterans who receive medical care through the VA also qualify for VA dental care services. Even veterans who qualify for oral health care may not be able to access it due to issues such as limited provider locations and long wait times. The new Congress and the administration have both indicated an interest in addressing veteran’s health issues, especially improving access to care for veterans who already qualify for care. We may not see massive reforms in the current political environment, but there could be important opportunities for incremental improvements in how oral health care is delivered. Oral health advocates should be prepared to talk about the importance of improving oral health care for veterans and the barriers to getting oral health care in the first place 

Supporting Water Fluoridation 
Decades of research show that fluoride plays a critical role in good oral health, and that our nation’s oral health crisis could be far worse if it were widely removed from drinking water. Oral health advocates have an important role to play in ensuring that their communities and law makers receive accurate information about water fluoridation amid reinvigorated debates on the topic. Efforts to roll back water fluoridation also make it even more important to advance policies that improve access to oral health prevention and care. 

Prioritizing Oral Health Prevention and Research 
The incoming Congress and administration have indicated interest in restructuring or cutting funds to agencies such as NIH, CDC, HRSA, and others — all of which conduct or fund oral health research and programs. At the same time, there has also been discussion about a renewed focus on chronic disease and nutrition that could tie into oral health prevention work. It will be important for oral health advocates to educate policymakers about the importance of programs in their state and the need for data and research to ensure we’re preventing oral health problems rather than paying for them later. 

These are some of the most defined issues we’ll be watching this year, but they won’t be the only ones. For example, we’re likely to see continued discussions around the health care workforce and telehealth that could have oral health implications. As the year progresses and policy discussions unfold, CareQuest Institute for Oral Health and the Oral Health Progress and Equity Network (OPEN) will continue to share on how advocates can get involved, speak up, and make a difference.