Dental care utilization stagnant among Medicaid beneficiaries
ADA Health Policy Institute finds that Medicaid reimbursement continues to lag in most states
Dental care utilization rates among children have remained unchanged for the past few years and are down from pre-pandemic levels. Further, the gap in utilization between children covered by Medicaid or the Children’s Health Insurance Program (CHIP) and children covered by private dental benefits is “not shrinking,” according to the latest findings from the ADA Health Policy Institute.
The latest data on the Medicaid dental landscape compiled by HPI indicate that the stagnancy in dental care utilization is mirrored in Medicaid participation rates among dentists. The share of U.S. dentists participating in Medicaid or CHIP is 41% as of 2024 — around the same as it was in 2015.
Dentist participation, overall, in Medicaid has not changed despite a decade of expansions to dental benefits for adults covered by Medicaid. As of 2025, 38 states and Washington, D.C. offer enhanced dental benefits to adults under the Medicaid program. Eighteen states have expanded their benefit offerings since 2021, and no state has cut back benefits, “reflecting progress in improving coverage for adult beneficiaries.” Still, there is a stark gap in dental care utilization between publicly and privately insured adults and children in most states.
Stagnancy in dentist Medicaid participation and beneficiary utilization may be largely attributable to reimbursement rate stagnation. Medicaid fee-for-service reimbursement in most states falls far below 50% of dentist charges and 60% of private insurance reimbursement. However, the recent HPI report notes that even with appropriate reimbursement for Medicaid services, access to care may still be an issue if “the numerous barriers to dental care that go beyond access to providers” are not addressed.
HPI will continue to monitor these trends and how they impact access to dental care for the U.S. population. View the full data, including state-by-state comparisons and trends over time on HPI's website.
The ADA offers Medicaid-specific resources for policymakers. See the ADA toolkits for Medicaid Programs available to help advocate for dental benefits under Medicaid.
