Cuts to Medicaid Endanger Dental Benefits for Older Adults

Takeaways

• For older adults, Medicaid is often the only source of adult dental coverage, which is not included in traditional Medicare.
• Oral health is essential to overall health, impacting chronic diseases, nutrition, and mental well-being, especially for seniors.
• Proposed budget cuts to the Medicaid program, such as those in the Budget Reconciliation Act of 2025, threaten to eliminate or weaken adult dental benefits.
• Protecting Medicaid’s dental benefits is vital for maintaining the health and quality of life of older adults as well as people with disabilities.

The national advocacy organization Justice in Aging recently called attention to the critical role that oral health care plays in the overall health and well-being of older adults and people with disabilities who rely on Medicaid for health coverage.

Medicaid is a joint federal-state health insurance program for people with low incomes that provides essential coverage that Original Medicare does not, including dental care for adults in most states. These vital services, however, often hang in the balance, targeted for reduction when budgets tighten despite their proven importance to overall well-being.

Although all states but one currently offer some adult dental coverage through the Medicaid program, these services are far from guaranteed, as proposed federal budget cuts now threaten to weaken or eliminate them. More than 36 million people nationwide are currently Medicaid enrollees.

Why Oral Health Matters for Everyone

Oral health goes far beyond just having a nice smile. Healthy teeth and gums are linked to overall health and quality of life in many important ways. Oral health:

• Affects daily living. Problems such as tooth decay, gum disease, or infection can cause pain and difficulty when eating, speaking, and concentrating.
• Connects to chronic disease. Research shows strong links between poor oral health and chronic conditions such as diabetes, cardiovascular diseases, aspiration pneumonia, and cognitive decline. Disease and inflammation in the mouth can influence inflammation elsewhere, and chronic health problems can also worsen dental issues.
• Influences mental and social well-being. Missing or painful teeth can affect self-esteem, social interaction, and mental health, especially when dental problems go untreated for years. Older adults may avoid social situations, eat softer (and often less healthy) foods, or suffer anxiety about their appearance.

Why Oral Health Is Especially Important for Older Adults

Older adults often face unique challenges that make oral health care especially important.

Higher Risk of Dental Problems

Many people age 65 and older experience tooth loss, gum disease, and root decay. These issues are often linked with the aging process, chronic diseases, and the use of some medications that can cause dry mouth.

Chronic Health Conditions Are Common

Roughly 85 percent of older adults have at least one chronic condition, and many have two or more. Chronic diseases and their treatments often increase oral health risks.

Cost Barriers Are Steep

Traditional Medicare does not cover routine dental care, and private insurance can be prohibitively expensive for people living on fixed or limited incomes. Medicaid may fill this gap, but coverage varies by state and benefits are often at risk.

Disparities Affect Access

Older adults living in rural areas and marginalized communities, especially people of color and those with disabilities, are more likely to have poorer oral health and face greater obstacles in accessing care. Medicaid coverage can help reduce these disparities, but cuts or reduced access to dental providers could widen them further.

Medicaid and Oral Health: What’s at Stake

Justice in Aging highlights how federal budget decisions, like the Budget Reconciliation Act of 2025 (H.R. 1), can threaten Medicaid funding and therefore adult dental benefits coverage. When states face tighter budgets, optional benefits such as adult dental care are often the first to be scaled back, even though cutting these services can lead to worsened health outcomes, increased use of costly emergency care, and higher long-term health care costs.

During times when adult dental coverage has been cut, such as in California in 2009, people without coverage have delayed needed care, suffered pain and infection, and ended up in emergency rooms for issues that proper dental care could have prevented.

A Call to Protect Oral Health Coverage

Oral health isn’t a luxury — it’s a fundamental part of overall health, especially for older adults and people living with disabilities. Safe, timely, and affordable access to dental care helps older adults:

• Eat well and maintain good nutrition
• Prevent infections and serious health complications
• Stay socially engaged and confident
• Manage chronic illnesses more effectively

Protecting and strengthening Medicaid dental benefits is not only a matter of fairness but also a smart investment in public health and long-term cost savings.

Additional Reading

For additional reading on topics related to Medicaid, check out the following articles:

• What Is the Difference Between Medicare and Medicaid?
• What to Do If You Lose Your Medicaid Coverage
• Receiving an Inheritance? Beware of Medicaid Income Limits
• Understanding Medicaid: What Does Medicaid Cover?
• Cuts to Medicaid Benefits May Harm Millions of Older Adults
• Medicare Part B: Doctor Visits and Preventive Care