Medicaid matters for oral health

by Ellen Allen. Originally published by West Virginia Watch, June 26, 2025.

Medicaid ensures 80 million Americans, and over 500,000 West Virginians, have access to health care. Importantly, Medicaid is also a core source of oral health care coverage for families across the country, which is critical to ensuring overall health and well-being.

Everything Medicaid is under attack and many of the greatest health achievements in the last 15 years  are about to be rolled back.

Medicaid is a critical lifeline to dental care for people with disabilities, kids and families with low incomes. Children enrolled in Medicaid have guaranteed, comprehensive dental benefits and Medicaid dental benefits are a significant driver of access to dental care for low-income working-age adults and seniors. Medicaid dental coverage also improves oral health outcomes for adults and children alike.

Additionally, Medicaid dental benefits are a driver of economic health for individuals and states. Adults with Medicaid dental coverage spend less out-of-pocket on dental care, helping them avoid medical debt and freeing up resources to meet their basic needs and engage in their local economy. For many adults, being able to afford dental care could be the key to getting a new job or advancing in their current one. When adults have Medicaid dental coverage, their job prospects and job performance improve. And adults with good oral health have more job opportunities. The improved oral health associated with Medicaid dental benefits could save states at least $273 million per year. Medicaid cuts will harm oral health.

According to Gina Sharps, West Virginia Oral Health Coalition executive director, numerous studies show that Medicaid adult dental coverage lowers overall health care spending on chronic disease management and emergency department usage. Emergency department visits alone cost an estimated $2.1 billion per year, and research indicates that nearly 79% of these visits could be addressed in a dental office — a potential savings of up to $1.7 billion per year. It also boosts oral health outcomes for patients and increases employment opportunities.

The high cost of dental care, particularly out-of-pocket costs, remains a major barrier to care. And for many families, Medicaid is one of the only affordable options to obtain oral health services. It is no wonder that it is also extremely popular, with over 74% of voters supporting better oral health access in Medicaid. However, adult dental services in Medicaid are considered “optional” for states and therefore at particular risk for being cut or scaled back if states lose Medicaid funding.

Current congressional proposals to cut or cap Medicaid to pay for tax cuts for billionaires would threaten the health and livelihood of tens of thousands of West Virginians. These cuts would lead to devastating dental coverage losses and ballooning medical debt, of which dental bills are already a key driver. In general, Medicaid cuts would push good oral health out of reach, causing avoidable dental problems to become emergencies and costing the health care system millions of dollars in unnecessary spending.

Reductions in federal Medicaid funding could lead states to roll back Medicaid expansion or cut program eligibility taking away health care from millions of seniors, kids and low- income adults. Additionally, the 23 million adults who rely on Medicaid for dental care would suddenly be left with nothing. In addition to reducing access to care and worsening oral health outcomes, dental coverage loses also decrease work productivity. Many adults who lose Medicaid coverage would go completely uninsured; some may be able to switch to private coverage through their state’s marketplace or their employer, but there are no requirements for private medical insurance to cover oral health.

Additionally, major changes or cuts to the program could also put access to kids’ oral health coverage at risk even though it is mandatory. Cuts to Medicaid oral health benefits would lead to immediate and lasting harm.

When families lose Medicaid coverage, they are more likely to go without oral health coverage than obtain expensive, private insurance. As a result, individuals forgo preventive care and early interventions, ultimately ending up in the emergency department for care at higher cost for the patient, hospital systems, states, and taxpayers.

Good oral health not only enables you to functionally perform as a human being — like speaking, smiling and eating — it is also important for communication, human relationships and financial prosperity. Poor dental health carries serious consequences that can lead to systemic and costly health conditions, such as oral health cancer and even heart disease.

This is especially the case for those who have the biggest obstacle in getting access to dental care — rural and lower income households.

Oral health is health and any cuts to Medicaid will have drastic consequences for both.