Star Quinn moved to Kingsport, Tennessee, in 2023, the same year the state began covering dental costs for about 600,000 low-income adults on Medicaid.
But when Quinn chipped a tooth and it became infected, she struggled to find a dentist accepting her government coverage and new patients. She ended up at an emergency room, receiving painkillers and antibiotics, but weeks later still paid $200 out-of-pocket to have the tooth extracted.
Years later, she says chewing on that side remains painful. “You should be able to get dental care,” Quinn, 34, told reporters. “At the end of the day, dental care is health care.”
Federal law requires Medicaid dental coverage for children, but adult dental benefits are optional. Several states have expanded coverage in recent years, recognizing its link to overall health. Yet in six states studied by KFF Health News, fewer than one in four Medicaid adults saw a dentist at least once a year.
Congressional Republicans’ One Big Beautiful Bill Act, signed into law last year by former President Donald Trump, is expected to cut Medicaid spending by more than $900 billion over a decade. States could see losses ranging from $184 million in Wyoming to $150 billion in California, potentially forcing reductions in adult dental benefits.
Tennessee’s Medicaid spent nearly $64 million on dental coverage in 2024, helping reduce dental-related ER visits by 20%, according to spokesperson Amy Lawrence. But the state is projected to lose about $7 billion in federal funding over the next ten years.
Currently, 38 states and the District of Columbia offer enhanced dental benefits for adult Medicaid beneficiaries. Alabama provides none. Since 2021, 18 states have added checkups, X-rays, fillings, crowns, and dentures while raising annual benefit caps. Even in states with expanded benefits, no more than a third of adult Medicaid recipients saw a dentist in 2022.
Recent state data show: Maryland — 22% (2024); Oklahoma — 16% (2025); Maine — 13% (2025); New Hampshire — 19% (2025); Tennessee — 16% (2024); Virginia — 21% (2025). By comparison, 50–60% of adults with private insurance see a dentist annually.
Participation remains low. Nationwide, 41% of dentists accepted Medicaid in 2024, a figure unchanged over the past decade. Many limit the number of Medicaid patients or refuse new enrollees, citing low reimbursement rates.
In southwestern Virginia, the Appalachian Highlands Community Dental Center treats about 5,000 patients annually, most on Medicaid, while 3,000 remain on a yearlong waitlist. Executive Director Elaine Smith said many patients have the coverage but not the access.
Other barriers include transportation, childcare, and work schedules. Poor dental health can contribute to heart disease, diabetes, and reduced quality of life. Robin Mullins, 49, drives 90 minutes for care in Clintwood, Virginia, after losing her lower teeth due to infrequent dental visits.
In New Hampshire, challenges stem more from low demand than supply. Northeast Delta Dental CEO Tom Raffio said the company added providers and mobile dental units and has publicized benefits widely. “Culturally, it’s going to take a while,” he said, noting many adults only seek care when in pain.
Brooks Woodward, dental director at Chase Brexton Health Care in Baltimore, described Maryland’s rate of one in five adult Medicaid patients seeing a dentist as encouraging, given that enhanced benefits began only in 2023. Many adults simply do not view regular dental visits as necessary.