States Have New Flexibility to Add Adult Dental Care to Essential Health Benefits

On April 2, 2024 CMS offered a new option for states to update their essential health benefits (EHB) benchmark plan to require coverage of routine adult dental benefits. Research has highlighted significant disparities in oral health outcomes for adults depending on their insurance status, race and income. For example, Black adults are twice as likely to have untreated dental caries as White adults. While there are multiple drivers of inequities in oral health, including limited access to dental providers, a primary barrier to accessing dental services is the cost of care, a barrier that can be reduced with dental insurance. A new expert perspective published by SHVS provides an overview of the newly available flexibility and discusses considerations for states weighing whether to add a requirement that plans subject to EHB cover routine adult dental care.