Dentists Appreciate Commitment to Rebuild Medicaid Program in CT

The Connecticut State Dental Association (CSDA) applauds the Connecticut General Assembly’s leadership, demonstrated this week at the State Capitol where House and Senate leaders unveiled a strategy to significantly bolster the state’s Medicaid program, which has been collapsing due to prolonged periods of underfunding.

The CSDA had sent an open letter to Governor Lamont last week, shared with legislative leaders, highlighting the critical deficiencies of the existing program and the growing struggles that Medicaid eligible patients were facing to access critical oral health care. As outlined by Senate President Pro Tempore Martin Looney, Speaker of the House Matt Ritter and others in leadership at a news conference Tuesday morning, the package will move towards a rate that matches what is currently being reimbursed in our sister states, as well as a parity between child and adult oral health care rates, which has been faltering since 2007.

CSDA had noted that “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. 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.”

“Continuing to neglect the Medicaid system will exacerbate short-term issues like tooth loss and increased ER 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.”

CSDA also pointed out that the American Dental Association (ADA) has found that there are an estimated 2 million visits to hospital emergency rooms for dental pain annually, with costs totaling approximately $1.7 billion, of which Medicaid covers about one-third. These emergency visits, which typically cost three times more than preventive dental care, represent an enormous and avoidable strain on both our healthcare system and state budget. In Connecticut we have seen significant numbers of ER visits for dental pain, particularly among Medicaid beneficiaries. These visits are driving up healthcare costs, when preventive care from a dental provider could save our system significant resources while improving patient outcomes.

“Medicaid is grossly underfunded and the result is that the reimbursements for providing oral health care to Medicaid patients comes nowhere close to the actual cost of providing the care. Our dentists are committed to providing all Connecticut patients with the highest quality of care, but we simply cannot afford to do so under the existing fee schedule,” said Dr. R. Steve Hall, President of the Connecticut State Dental Association.

“The system is collapsing because there are no longer enough providers to care for the eligible population,” he added. “Without a reasonable fee structure, access to care will continue to crumble, meaning that patients cannot access the care they deserve in the timeline necessary to avoid prolonged pain, interference with routine life activities and leading to chronic illness, including extractions on teeth that could have been saved if care could be accessed.”

The CSDA letter also indicated that “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. Historical rate inequities and a growing Medicaid population — 60% of whom are adults — have already led to a shrinking provider network, an 11% contraction from 2020-2023, and longer wait times, threatening the program’s viability and the health of eligible patients.

According to the Connecticut Dental Health Partnership (CTDPH), average appointment wait times have steadily increased, now averaging 23 days for both children and adults. The percentage of providers not accepting HUSKY adult patients has risen significantly, from 22% in 2017 to 39% in 2024. Wait times for endodontic specialists have also seen a substantial rise since 2023, increasing by 57 days for adults and 26 days for children, primarily due to the limited number of endodontic specialists within the network”.

On behalf of thousands of patients who rely upon the Medicaid system for essential oral health care, CSDA stands committed to working with the General Assembly and the Governor to prioritize Medicaid Dental Reimbursement Rates, particularly for preventive care. By raising reimbursement rates and addressing barriers to care, we can increase the number of providers willing to serve Medicaid patients, prevent costly ER visits, and improve overall public health outcomes in Connecticut.

Data from the American Dental Association’s Health Policy Institute (HPI) reveals that across eight states, nearly 60% of Medicaid beneficiaries struggle to access dental care, and Connecticut is no exception. 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.

Additionally, 40% of enrollees encounter prohibitive out-of-pocket costs or a lack of covered services, further limiting their ability to maintain oral health. This lack of access forces many patients into emergency rooms for conditions that could have been treated preventively in a dental office.

The CTDHP model exemplifies the power of prevention, focusing on early, routine care for children and transitioning adults from neglect to ongoing maintenance. Since adopting this approach in 2008, Connecticut has saved approximately $1.25 billion by reducing costs and avoiding unnecessary treatments, underscoring the critical need to prioritize preventive care to further reduce costs and improve health outcomes.

At the news conference, Speaker Ritter said “We understand what's going on nationally and we won't stop putting forth good policies. We want to increase Medicaid rates. This has been long overdue for 17 years.”

Senate President Looney explained “We know we have rates for children that are just too low and providers won't offer care. We want to move forward with an increase to Medicaid services but we don’t know how severe the federal cuts will be. We may have to do a substantial budget after June fourth (last day of the session) depending on what happens. The federal government is not bound by our June fourth deadline. We have over 2000 state employees paid with federal funds. We are here today to put down a marker for Medicaid.”

Deputy Majority Leader Senator Matt Lesser, Co-Chair of the Human Services Committee, said “It occurred to me that in the Medicaid program we are still asking providers to accept 57% of what Medicare paid in 2007. We do this because we haven't been able to, due to fiscal decline, make these meaningful investments. We are going to try and peg this so that we don’t have to come back year after year. We need a rational system.” Added State Rep. Jillian Gilchrest, House Co-Chair of the Human Services Committee: “We will be increasing Medicaid rates. 1/3 of children receive care through Medicaid rates. The wages that can be provided are lower than other states and this leads to a workforce issue.”