Star Quinn moved to Kingsport, Tennessee, in 2023, the identical yr the state started overlaying dental prices for about 600,000 low-income adults enrolled in Medicaid.
However when Quinn chipped a tooth and it grew to become contaminated, she couldn’t discover a dentist close to her house who would settle for her authorities well being protection and was taking new sufferers.
She went to an emergency room, receiving painkillers and antibiotics, however she remained in agonizing ache weeks later and paid a dentist $200 to extract the tooth.
Years later, it nonetheless hurts to chew on that aspect, she mentioned, however Quinn — a 34-year-old who has 4 kids and, along with her husband, earns about $30,000 a yr — nonetheless can’t discover a dentist close by.
“It’s best to be capable to get dental care,” she mentioned, “as a result of on the finish of the day dental care is well being care.”
The federal authorities has lengthy required states to supply dental protection for kids enrolled in Medicaid, the joint state-federal well being program for people who find themselves low-income or disabled. Paying for adults’ dental care, although, is non-compulsory for states.
Lately, a number of states have opted to broaden the protection supplied by their Medicaid packages, in search of to spice up entry in recognition of its significance to general well being. To date, growing grownup dental care is a piece in progress: In a sampling of six of these states by KFF Well being Information, fewer than 1 in 4 adults on Medicaid see a dentist no less than every year.
However below congressional Republicans’ One Huge Lovely Invoice Act, which President Donald Trump signed into legislation final yr, the federal authorities is anticipated to cut back Medicaid spending by greater than $900 billion over the subsequent decade. The anticipated 10-year losses for particular person states vary from about $184 million for Wyoming to about $150 billion for California.
State Medicaid packages usually broaden or cut back advantages relying on their funds, and such large federal cuts might power some to shrink or get rid of what they provide, together with dental advantages.
“We’ll lose all of the features we’ve got made,” mentioned Shillpa Naavaal, a dental coverage researcher at Virginia Commonwealth College in Richmond.
Tennessee’s Medicaid program, as an illustration, spent almost $64 million on its dental protection in 2024 and noticed a 20% lower in dental-related ER visits, mentioned Amy Lawrence, this system’s spokesperson.
However below the brand new legislation, Tennessee is projected to lose about $7 billion in federal funding over the subsequent decade.
As of final yr, 38 states and the District of Columbia supplied enhanced dental advantages for grownup Medicaid beneficiaries, based on the American Dental Affiliation. Many of the others provide restricted or emergency-only care. Alabama is the one state that gives no dental protection for grownup beneficiaries.
Since 2021, 18 states have enhanced their protection to incorporate checkups, X-rays, fillings, crowns, and dentures, whereas loosening annual greenback caps for advantages.
Use of dental advantages in states with the improved advantages is larger than in states with solely restricted or emergency protection, although nonetheless low general, based on an ADA report with the most recent information as of December. Not more than a 3rd of grownup Medicaid recipients noticed a dentist in 2022 in any state.
To assessment newer progress, KFF Well being Information requested one-third of the states which have expanded their advantages previously 5 years for his or her most up-to-date information on the proportion of adults on Medicaid who go to a dentist no less than every year:
- Maryland — 22% (in 2024)
- Oklahoma — 16% (in 2025)
- Maine — 13% (in 2025)
- New Hampshire — 19% (in 2025)
- Tennessee — 16% (in 2024)
- Virginia — 21% (in 2025)
Compared, about 50% to 60% of adults with personal dental protection see a dentist no less than every year, based on the ADA.
Nationwide, 41% of dentists reported taking part in Medicaid in 2024, a share that has remained secure over the previous decade regardless of the dental profit expansions in lots of states, the ADA says. Many taking part dentists, although, restrict the variety of Medicaid enrollees they deal with, and a few won’t settle for new sufferers on Medicaid.
Reimbursement charges haven’t stored up with prices, deterring dentists from accepting Medicaid, mentioned Marko Vujicic, chief economist and vp on the ADA Well being Coverage Institute.
Due to an absence of dentists who take Medicaid in southwestern Virginia, the Appalachian Highlands Neighborhood Dental Heart in Abingdon sees sufferers who journey greater than two hours for care — and should flip many away, mentioned Elaine Smith, its govt director.
The middle’s seven residents handled about 5,000 sufferers final yr, most of them on Medicaid. About 3,000 individuals are on its waitlist, ready as much as a yr to be seen.
“It’s unhappy as a result of they’ve the means now to see a dentist, however they nonetheless don’t have a dental house,” Smith mentioned.
Low-income adults face different boundaries to dental care, together with an absence of transportation, little one care, or break day work, she mentioned.
The lack to see a dentist has penalties broader than tooth ache. Poor dental well being can contribute to a bunch of different important well being issues, similar to coronary heart illness and diabetes. It will possibly additionally make it tougher to do issues like apply for jobs and customarily lead a wholesome life.
Robin Mullins, 49, who has been on and off Medicaid since 2013, mentioned an absence of normal dental visits contributed to her dropping her backside tooth. Unable to discover a dentist close to her house in rural Clintwood, Virginia, she drives virtually 90 minutes to Smith’s clinic — that’s, when she will afford to get time away from driving for DoorDash or discover assist watching her daughter, who has particular wants.
She will get by with partial dentures however misses her pure tooth, she mentioned. “It’s completely horrible, as you may’t chew your meals correctly.”
In New Hampshire, although, the challenges have extra to do with low demand than a low provide of dentists, mentioned Tom Raffio, chief govt of Northeast Delta Dental, which manages the state’s Medicaid dental program. The corporate has added new dentists to its listing of taking part suppliers, together with two cell dental models that traverse the state, he mentioned.
Raffio mentioned Northeast Delta Dental additionally has publicized the state advantages utilizing radio promoting and social media, amongst different efforts.
Till 2023, New Hampshire Medicaid lined solely dental emergencies.
“Culturally, it’s going to take some time,” he mentioned, “as folks simply are used to not going to the dentist, or going to the ER when have dental ache.”
Brooks Woodward, dental director at Baltimore-based Chase Brexton Well being Care, referred to as Maryland’s price of roughly 1 in 5 adults on Medicaid seeing a dentist in 2024 “fairly good” contemplating the advantages had been enhanced solely since 2023.
Woodward mentioned many adults on Medicaid imagine that you simply go to a dentist solely whenever you’re in ache. “They’ve at all times simply not gone to the dentist, and that’s simply the best way they’d it of their life,” he mentioned.
