Oral Health Leaders Urge Congress to Strengthen Adult Dental Coverage in All State Medicaid Programs 

The undersigned organizations urge Congress to strengthen Medicaid by ensuring that all state programs offer to all enrollees dental benefits necessary to maintain optimal health.

For too long oral health has been disassociated from systemic health, even though the evidence supports a relationship between oral health and overall health. And because policies have traditionally separated the mouth from the rest of the body, access to affordable oral health care remains out of reach for many low-income families and individuals, people with disabilities, communities of color, Tribal communities, and rural communities. Using a new coverage checker, 47 state Medicaid programs are not currently offering dental benefits sufficient to maintain optimal oral health. It’s time for health care policies to reflect the needs and wants of constituents in their pursuit of whole-person health. By requiring extensive Medicaid adult dental benefits for all state Medicaid programs, Members of Congress can be a part of the solution to promote positive health outcomes, address health inequities, provide economic opportunity in their communities, and curb healthcare costs.

Medicaid dental coverage for adults is one of the few options available for low-income families, who are seeking oral health care. Because Medicaid dental coverage for adults is not a required or defined benefit, coverage varies drastically by state and is often in flux given its tie to state budgets Due to coverage instability, patients are vulnerable to disruptions in their continuum of care, making it difficult to maintain health. This also means that providers face challenges in maintaining continuity of care. Requiring extensive dental benefits in each state Medicaid program would eliminate the disparity to accessible, affordable treatments, and ensure that everyone is able to get the care they need, regardless of what state where they reside.

Research clearly demonstrates that oral health is integral to general health and the management of multiple chronic diseases. Access to routine, preventive dental care can offset the cost of expensive and unanticipated problems in chronic disease maintenance in conditions such as diabetes, heart disease, and behavioral health conditions. A recent study conducted by the American Dental Association Health Policy Institute estimates $273 million per year in medical care savings if extensive dental services were offered in the 28 state Medicaid programs where they are restrictive (data from early 2021).

Moreover, adults who are unable to afford routine dental care experience a disproportionate share of oral disease, and are often left to seek treatment in the emergency departments. ED visits are exponentially more expensive than preventive care and are often limited to treatments for pain relief or antibiotics for infection. This results in a waste of public resources - nearly $2 billion annually - and places an unnecessary financial burden on the state, hospital, and patients while only temporarily addressing the dental need. These costs could largely be avoided if everyone had access to meaningful dental coverage.

Good oral health is linked to improved quality of life. The ability to eat free of pain and have the confidence to speak and smile without embarrassment impact an individual’s day-to-day well-being. Furthermore, poor oral health can lead to lost workdays and reduced employability, undermining an individual’s opportunity for economic prosperity.

Consumer advocates and provider groups support the advancement of extensive Medicaid adult dental benefits in all states. The organizations listed below represent a diverse cross-sector in the dental landscape including providers, consumer advocates, dental plans, dental service organizations, dental practices, payers, dental supply manufacturers, state dental boards, community clinics, the public health community, government, academia, and philanthropy. We stand ready to serve as a resource and to work aside Congress to ensure improved oral health and overall health outcomes for all communities.