Medicaid Dental Benefit Act

Full Title:
Medicaid Dental Benefit Act of 2026

Summary#

This bill would make dental and oral health services for adults a mandatory Medicaid benefit starting January 1, 2028. It defines covered dental and oral health services to include dentures, implants, prevention, treatment of oral disease, relief of oral pain, and emergency oral care when provided by a legally authorized provider. States may add extra dental items and services at their option. For the 50 states and the District of Columbia, the federal share (FMAP) for covered adult dental spending would be 100 percent for a 12-quarter period beginning January 1, 2028. Territories may receive 100 percent FMAP for a 12-quarter period that begins the first quarter after they start covering the service. The 100 percent FMAP does not apply to optional additional items added by a State after enactment or to items already covered before enactment.

The bill requires development of a core set of adult oral health quality and equity measures, with timelines: recommended measures and an initial core set within 1 year, standardized reporting formats within 2 years, and regular reports to Congress. States must submit annual reports on their adult oral health measures, benefits, reimbursement, and plans to reduce oral health disparities. The bill authorizes $10,000,000 to carry out the quality and equity measures section. It also directs the Medicaid and CHIP Payment and Access Commission to report to Congress within 2 years on adult oral health issues, coverage, barriers, innovations, and the impact of the bill's Medicaid changes.

The Secretary of Health and Human Services must create an outreach and education program within 1 year to provide culturally and linguistically appropriate information, help connect adults to care, train providers in culturally competent care, and offer interactive adult oral health education.

What it means for you#

  • If you are an adult enrolled in a State Medicaid plan (or waiver), the plan must cover dental and oral health services described in the bill beginning January 1, 2028. Coverage includes preventive care, dentures and implants, treatment for oral disease, and emergency dental care when provided by an authorized provider.
  • If you live in a U.S. territory, coverage of these adult dental services is optional for that territory; if the territory begins coverage, much of the federal share may be 100 percent for a 12-quarter period starting when the territory first covers the services.
  • States must collect and report data on adult oral health quality and equity. That means more information about service use, emergency dental visits, and care for people with specific medical needs will be tracked and published.
  • The bill requires outreach and education programs to help eligible adults learn about and access dental benefits, and it requires provider education on culturally competent care.

Expenses#

  • The bill authorizes $10,000,000 to carry out the adult oral health quality and equity measures section.
  • For 12 quarters beginning January 1, 2028, the Federal Medical Assistance Percentage (FMAP) for adult dental and oral health services authorized under the bill would be 100 percent for the 50 states and the District of Columbia. Territories may receive 100 percent FMAP for a 12-quarter period that begins when they first provide the covered services.
  • The bill states that the 100 percent FMAP does not apply to optional additional services a State adds under the new optional category, nor to items already covered as of enactment.
  • No publicly available information on total projected federal or state costs beyond the provisions above.

Proponents' View#

No publicly available information.

Opponents' View#

No publicly available information.