Some dentists are worried about potential cuts to Medicaid and other dental programs threatening the viability of smaller dental practices and the profession itself, but others are not as concerned with some of the potential cost-saving measures.
The U.S. House of Representatives recently passed the budget reconciliation package, which has many provisions that will impact dentists and the dental industry. There are aspects that may positively impact the industry, while others may harm dentistry.
These five dentists recently connected with Becker’s to share their thoughts on the potential budget package and how it could affect the profession and the delivery of dental care.
Note: Responses were lightly edited for clarity and length.
Question: What impact do you believe the budget reconciliation package that was recently passed in the House of Representatives to impact will have on the dental and/or healthcare industries?
Corey Anderson, DDS. Dentist of Affordable Dentures & Implants (Bridgeport, W.Va.): Dental needs continue to grow. Dental operating costs continue to grow. The base number of total dental providers continues to decline. Dental insurance reimbursement rates flatlined years ago. Private pay patients have a declining ability to pay out of pocket without private financial arrangements. Neither private nor public dental insurance remain relevant in terms of the last 30 years of market changes, technology changes and patient demographics with regards to dentistry. If the current reconciliation package becomes finalized, it seems as if millions of people will be deemed ineligible for dental benefits under the public insurance plans under Medicaid and Medicare Advantage. The resulting patients will either become Mission of Mercy/Remote Area Medical clinic patients, private pay/private financing patients or flood the emergency rooms with untreated dental conditions that become life threatening.
Robert Baskies, DMD. (Phillipsburg, N.J.): Though there is a movement to cut the number of patients off of the Medicaid roles, I doubt that it will happen. Next year all of the House of Representatives are up for election. Would you want to be the representative that cut people off of Medicaid? Do you want to be elected? There may be some structural changes such as having to reapply every six months and a work/training requirement, but there will not be a Medicaid tsunami. Nothing will happen to Medicare. This is a supercharged third rail. I think that United HealthCare is going to have some problems because they manipulated the way they billed Medicare. Their stock is down about 40% and this may impact the cost of their Medicare Supplement program, but they are too big to fail.
Mike Davis, DDS. Dentist of Smiles of Sante Fe (Albuquerque, N.M.): The bill passed in the U.S. House has not been passed in the Senate. Once the U.S. Senate passes a reconciliation bill, it must then go to joint Conference Committee of the two branches of the legislature, for the final wording. Then this bill must be passed by both branches of the legislature, prior to a signature into law by the President. My point is that we are still far off from a finalized reconciliation package.
I have two concerns with the current House reconciliation bill. Firstly, small business dentistry often utilizes pass-through entity tax deduction structures. The current bill would in effect create a double taxation for numbers of small business dental practices. I suspect that will be amended in conference.
Secondly, numbers of legislators and the American Dental Association are troubled by any cutbacks to the adult dental Medicaid program. Most of that boils down to a return of work requirements for able-bodied adults to receive Medicaid benefits.
We saw similar positive cost-cutting legislation worked out under former President Bill Clinton and U.S. House Speaker Newt Gingrich in the late 1990s. Adult Medicaid work requirements were an essential step in balancing the federal budget.
Therefore, I do not find the apparent savings by cuts in the adult dental Medicaid program as upsetting. The loss of a few adult Medicaid patients will be more than offset by an entitlement program, which is perceived fairer to taxpayers.
George Hanna, DMD. CEO of New Mexico Dental Clinics (Rio Rancho): If Medicaid dental coverage is restricted, dental providers may see a decrease in the number of patients with coverage. This could result in reduced revenue and might lead some practices, especially those that rely heavily on Medicaid, to cut services or even close down. We are already observing a growing number of dental clinics in New Mexico and Pennsylvania reduce their staff and operations. The dental and healthcare industries will be significantly affected if these new policies are not thoroughly evaluated.
Krista Kappus, DDS. Dentist of Fitch Mountain Dental (Healdsburg, Calif.): The recently passed budget reconciliation package is likely to place additional strain on an already overburdened dental and healthcare system. While the bill may be positioned as a means to reduce federal spending, its impact on access to care and workforce sustainability cannot be ignored.
One of the most concerning aspects is the potential reduction in funding and support for low-income populations. Cuts to Medicaid or related subsidies could significantly reduce access to both dental and medical care for underserved families. Historically, dental care has been one of the first areas to be deprioritized in tight budgets, and this trend may worsen — turning what should be basic preventive care into a luxury that many can no longer afford.
Additionally, the reduction or elimination of student loan forgiveness programs will likely deter new graduates from entering already underserved areas of healthcare. With dental and medical education costs already soaring, fewer professionals may be willing to assume the financial burden required to enter these fields — especially in rural or low-income communities. This will only exacerbate the existing shortages of both dentists and physicians, leading to longer wait times, overextended providers, and diminished quality of care.
Rising operational costs, combined with decreased tax relief for small healthcare practices, will further pressure private dental offices. Many independent practices will find it increasingly difficult to remain financially viable. As a result, private dental offices will likely continue to shrink and sell into DSOs, which can leverage economies of scale to negotiate higher insurance reimbursement rates and benefit from bulk purchasing discounts. While this consolidation may provide some operational stability, it often comes at the cost of personalized patient care and local practice autonomy.
In the long term, if this trajectory continues, dental care risks being seen less as a component of essential health and more as an elective service — deepening health disparities and contributing to systemic inequality. Overall, while the bill may offer short-term fiscal savings, its long-term consequences for the healthcare and dental systems could be profoundly damaging, particularly for the most vulnerable populations.
