Behind the Cuts: What’s at Stake in Medi-Cal Dental

Dental deserts and dental care shortage areas at the block group level from Harvard open-access article distributed under CC-BY License. ©2024 Rahman, MS, et al. JAMA Network Open

When Access to Care Is on the Line:
A Reflection on Medi-Cal Dental Budget Cuts from a Longtime Advocate

As a healthcare strategist, executive, and consultant with decades of experience navigating Medicaid-funded systems, I’ve spent much of my career advocating for scalable, equitable care models. I’ve worked directly with policy stakeholders, led clinical growth strategies in high-need areas, and pushed for reforms that center both patient outcomes and delivery system sustainability.

So when budget decisions emerge that risk unraveling progress — like California’s proposed $861 million reduction to Medi-Cal Dental — lI feel a responsibility to speak up.

The Policy Shift and Its Potential Fallout

The proposed budget includes sweeping reimbursement cuts — lincluding a 62% reduction for certain general anesthesia services. These cuts jeopardize access for patients who already face barriers, particularly children with special needs, those in rural regions, and families navigating complex care.

We’ve made slow but steady gains since the reinstatement of adult dental benefits in 2014 and the investment of Proposition 56 funds. Undoing that now, without a viable alternative, could destabilize access — lespecially in the most vulnerable zip codes.

Drawing on Systems-Level Insight

Independent data shows why this moment matters:

• Access gaps are persistent and measurable:
  According to the Sacramento Geographic Managed Care (GMC) Evaluation, only 38% of children in GMC plans received preventive dental services—compared to 49% in comparable FFS regions. This mirrors statewide trends.

• Utilization remains below state benchmarks:
  The state’s goal is 60% annual dental utilization among Medi-Cal enrolled children, yet only 47.6% receive care in any given year. That’s not just a statistic—it’s a gap of nearly one million children without preventive services.

• Dental-related ER visits remain a costly and inefficient backup:
  Dental conditions are one of the top preventable causes of pediatric emergency visits. A single visit can cost more than $2,000, yet address none of the long-term oral health needs of the child.

Policy Needs Context, Not Just Cost

Dental services account for a very small fraction of total Medi-Cal spending—estimated at less than 2%. But the downstream consequences of dental neglect ripple across education, workforce readiness, and chronic health.

We know prevention works. We also know that retention of dental providers in Medi-Cal is driven by more than reimbursement: it’s tied to predictability, administrative burden, and the perceived viability of the program. Cutting funding without reform only amplifies structural issues.

A Call to Action for Balanced Advocacy

I’ve long supported the efforts of organizations like the California Dental Association (CDA) and American Dental Association (ADA), who advocate with transparency and data-driven intent. Their latest responses to the proposed budget reflect the kind of pragmatic leadership we need now — lcalls not just for more funding, but smarter deployment of it.

Take Action Now

The proposed Medi-Cal Dental cuts threaten to reverse years of progress in expanding access to essential oral health services for vulnerable populations. As a longtime advocate, I urge you to make your voice heard.

For California Residents:

The California Dental Association (CDA) has made it easy to contact your state legislators. Visit the CDA Action Center to send a message urging them to reject the proposed Medi-Cal Dental budget cuts.

For Advocates Nationwide:

The American Dental Association (ADA) is actively working to improve Medicaid dental benefits across the country. You can support these efforts by visiting the ADA Advocacy page to learn about key issues and how to get involved.

Every voice counts in the fight to maintain and improve access to dental care for all. Join us in advocating for policies that prioritize oral health as a critical component of overall well-being.

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SOURCES

Primary Sources (Official Data & State Reports)
• California Department of Health Care Services (DHCS)
• Governor’s May Revise – California Department of Finance (DOF)
• Sacramento GMC Evaluation Report (2015)
• Medi-Cal Dental Performance Dashboard

Professional Advocacy & Policy Organizations
• California Dental Association (CDA) – Advocacy Hub
• American Dental Association (ADA)
– ADA News on Medicaid Cuts
– Medicaid Advocacy Resources

Supplementary National Sources (Health Policy & Research)
• Kaiser Family Foundation (KFF) – Medicaid & Dental Coverage
• Health Affairs – Policy Journal
• California Budget & Policy Center – Health Equity Analysis