Dentists raise alarm about Medicaid reimbursements

The Connecticut State Dental Association (CSDA) is concerned about Medicaid reimbursement rates, and is asking Gov. Ned Lamont for help.

On Jan. 24, the President of the CSDA, Dr. R Steve Hall, sent a letter to Lamont about a “pressing access-to- care crisis within our state’s Medicaid dental program.”

Hall, who claimed to speak on behalf of the 3,427 licensed dentists in the state, said that low Medicaid reimbursement rates are causing less doctors to treat Medicaid patients and discouraging Husky Health recipients from seeking dental care.  

“While we understand the enormous fiscal pressure our state faces to fund the state pension program and applaud your Administration’s efforts to address the neglect of that program, where there were no state contributions for four decades, and inadequate contributions until recent years,” the letter states. “However, continuing to stick to strict financial guardrails prioritizes pensions over critical medical care of our citizens, care that they deserve, and which is essential to their overall health.”

When it comes to dental care, there are 29 underserved populations in Connecticut, and 40 dental professional shortage areas. 

“This crisis stems from a shortage of Medicaid-enrolled providers, language barriers, and the absence of culturally appropriate care, leaving many of our state’s most vulnerable populations without the essential dental care they need,” the letter states. 

The Connecticut Dental Health Partnership (CTDHP) found that Husky dental services in Connecticut are significantly underutilized, according to a 2023 report. The impact of this various based on ethnicity, age and sex. Asian adults and children significantly underutilize dental services. One in five Asian third graders need early or urgent dental care—the largest percentage out of any race or ethnicity. 

Men are twice as likely to develop dental problems due to underutilization than women. Oral and oropharyngeal cancers are twice as in common in men than in women, and men are more likely to have periodontal disease. 

Although women were only slightly more likely to have a dentist, women tend to floss and brush more, and smoke less. 

“Continuing to neglect the Medicaid system will exacerbate short-term issues like tooth loss and increased [emergency room] visits for treatable dental pain, while the long-term effects, including missed screenings for conditions like oral abscesses, hypertension, diabetes, coronary disease, and mental health disorders, are truly alarming.”

The average emergency room visit for dental pain among Medicaid beneficiaries’ costs $749, the letter states. In contrast, the average dental cleaning costs between $100 and $300 without insurance.  

In 2008, the CTDHP adopted a model that focused on routine and preventative care. CSDA estimates that this saved the state $1.25 billion since its implementation, by reducing the number of high-cost treatments. 

However, 40% of Medicaid enrollees have to deal with “prohibitive” out-of-pocket costs or need treatment that is not covered by Medicaid plans, the letter states. 

“Routine oral health exams provide critical early intervention, yet Medicaid dental reimbursement in Connecticut has failed to keep pace with rising costs, with fee schedules deeply discounted compared to average dentist charges,” the letter state.

State Comptroller Sean Scanlon earlier this week proposed raising Medicaid reimbursement rates as part of the suggestions made in the 2025 Healthcare Cabinet Report. The Connecticut Hospital Association claims the state’s low reimbursement is contributing to hospital operating deficits, endangering the financial health of those institutions.

The CHA praised Scanlon’s proposal to increase Medicaid reimbursement, saying it will “address a significant funding gap that creates barriers to patients.”

Hall argues that dentists aren’t treating Medicaid patients because of the low reimbursement rates. Across the board, medical providers tend to make significantly less money on Medicaid patients than patients using private insurance. 

“By raising reimbursement rates and addressing barriers to care, we can increase the number of providers wiling to serve Medicaid patients, prevent costly ER visits, and improve overall public health outcomes in Connecticut.”

The CSDA could not be reached for questions.