Dentists across Massachusetts fear that Gov. Maura Healey\u2019s proposal to place a $1,000 annual cap on MassHealth dental coverage would drastically reduce services for nearly 2 million Bay Staters.<\/p>\n
Oral health advocates are pressing the Healey administration to restore full adult dental benefits under MassHealth in the governor\u2019s $63.4 billion budget request for next fiscal year. Under a $1,000 annual cap, they fear a sharp decline in access to preventive and restorative care.<\/p>\n
State officials, though, argue that President Trump\u2019s One Beautiful Bill is causing them to balance sustainability and costs, as they fear a loss of about $3.5 billion in annual federal healthcare funding once the act is fully implemented.<\/p>\n
The Healey administration estimates an annual cap on dental benefits could save $120 million. State Rep. Russell Holmes, a Boston Democrat, is urging officials to consider an annual cap of $2,500.<\/p>\n
Holmes says that a dentist in his Mattapan district has told him that 80% of his clients are on MassHealth, the state\u2019s Medicaid program. The dentist worries that a cap wouldn\u2019t allow him to provide the maximum care possible.<\/p>\n
\u201cI am very thankful to have dentists in the Mattapan area focused on MassHealth,\u201d Holmes said during a budget hearing on Friday, \u201cbut he\u2019s concerned that many of them will go out of business if we take it to this level.\u201d<\/p>\n
The cap does not apply to pediatric dental benefits.<\/p>\n
Bay Staters with MassHealth already face challenges in accessing dental care.<\/p>\n
The Massachusetts Health Policy Commission reported in 2021 that roughly 45% of dentists across the state accepted MassHealth, with 78 dentists per every 100,000 population, a rate it said was higher than the national average.<\/p>\n
MassHealth spent roughly $270 million on adult dental services last fiscal year, according to officials.<\/p>\n
Health and Human Services Secretary Kiame Mahaniah described the proposal to cap MassHealth adult dental benefits at $1,000 annual as a \u201ctough decision.\u201d He admitted that he\u2019s \u201cvery aware\u201d that many Bay Staters would \u201cexceed\u201d the limit with the services they need.<\/p>\n
The Healey administration studied adult dental benefit programs in states that Mahaniah said Massachusetts \u201cfollows philosophically.\u201d Caps in those states are $750 to $1,500 annually, he added.<\/p>\n
\u201cThe goal is, \u2018How do we maintain the service for a majority of people while being able to sustain all of MassHealth and not swallow up the rest of the budget?\u2019\u201d Mahaniah told the Joint Committee on Ways and Means on Friday.<\/p>\n
\u201cIn terms of what the amount will be,\u201d the health and human services secretary added, \u201cthankfully, I have a whole Legislature to decide what that cap will be. I would say that a cap is definitely something that\u2019s there.\u201d<\/p>\n
The Massachusetts Dental Society, representing over 5,000 dentists, is putting the heat on lawmakers to reconsider the cap proposal.<\/p>\n
Society President Steven Spitz, a dentist based in Brookline, wrote a letter earlier this month about how the state is still recovering from a significant reduction in MassHealth adult dental benefits in 2010. About 100,000 fewer adults received care through the program.<\/p>\n
Restorative services \u2014 fillings, root canals, crowns and dentures \u2014 were eliminated under those cuts. The Baker administration fully restored the benefits for adults in the state\u2019s Fiscal Year 2021 budget.<\/p>\n
\u201cThis access gap led to worse oral health outcomes and higher costs elsewhere in the healthcare system,\u201d Spitz wrote. \u201cUntreated dental disease increasingly resulted in avoidable emergency department visits \u2014 settings that are costly and unable to provide definitive dental care. This was all preventable.\u201d<\/p>\n
\u201cAny cuts to MassHealth dental funding in FY2027 would risk repeating these same mistakes and compounding prior harm,\u201d he added.<\/p>\n
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