The “Great American Act,” a proposal championed by former President Donald Trump, would reshape the U.S. Medicaid system by cutting over $1 trillion in funding over the next decade. For dental practices, which rely heavily on Medicaid reimbursement, the impact could be profound.
The bill would overhaul how federal and state governments administer Medicaid. The most significant updates for dental providers include:
Work requirements: Starting January 1, 2027, able-bodied adults without dependents must work at least 80 hours per month to remain eligible.
Funding mechanism reductions: Starting in 2028, the provider tax and federal matching subsidy would be cut.
Tighter eligibility rules: States would implement stricter documentation and verification procedures, making it more difficult for patients to qualify and maintain coverage.
Dental practices are bracing for operational and financial challenges as states implement new federal guidelines.
Tighter work and eligibility rules could result in many patients losing Medicaid coverage. Practices could face a surge in denied claims, delayed payments, and administrative confusion, placing significant strain on front-office operations.
More complex verification processes will force staff to spend more time confirming coverage. What used to be a single eligibility check may now require logging into multiple systems, verifying employment records, and confirming work hours.
Many patients may mistakenly believe they still have coverage, only to discover their plans have lapsed. This can lead to unexpected billing, eroded trust, and decreased appointment adherence—further widening the dental care access gap.
With Medicaid reform rolling out between 2026 and 2028, practices will need to navigate more complex insurance workflows—going far beyond basic eligibility checks. Practices must understand:
Deductibles and coverage limits
Treatment frequency caps
Coordination with other insurance plans
Patient payment responsibilities
Studies show that 90% of dental patients postpone routine care due to cost, and 80% postpone emergency care. Clear cost estimates and transparent billing are critical to maintaining patient trust and financial stability.
The Dentist’s Bottom Line
The Great American Act marks a turning point for Medicaid dental providers. Reduced incentives and stricter regulations will require practices to prioritize claims accuracy and proactive communication.
Practices that invest in smarter, more streamlined insurance verification systems can not only minimize claim denials but also provide a better patient experience.
As states gradually implement new federal regulations, dental practices that prepare ahead of time will be best positioned to maintain growth in an increasingly challenging healthcare environment.