Some dental practice owners and DSO executives are concerned with the possibility of cuts to the federal Medicaid budget, which they say could threaten dental care accessibility, practice revenue and the workforce.
The House Budget Committee released its budget blueprint for Fiscal Year 2025 Feb. 12, and voted to advance the resolution to the full House for approval. The proposal directs House committees to cut spending by at least $1.5 trillion, with the goal of reducing spending by $2 trillion over 10 years. The Energy and Commerce Committee, which is responsible for matters related to public health and the Department of Health and Human Services, is specifically being asked to cut $880 billion over the course of a decade.
The directive has led government officials and healthcare works to believe that cuts to Medicaid and other safety net programs are likely. Lawmakers are now being urged to avoid cuts to such programs.
"While some have suggested dramatic reductions in the Medicaid program as part of a reconciliation vehicle, we would urge Congress to reject that approach," Rick Pollack, President and CEO of the American Hospital Association said Feb. 12. "Medicaid provides healthcare to many of our most vulnerable populations, including pregnant women, children, the elderly, disabled and many of our working class."
Cuts to Medicaid could have a major impact on dental care, adding to the existing mountain of accessibility challenges facing the industry.
The ADA estimated in 2022 that 1 in 3 dentists in the U.S. treat Medicaid patients, while about 23 million adults and several million children rely on Medicaid for dental coverage.
Funding cuts could result in millions of people losing access to dental care, according to the CareQuest Institute for Oral Health.
"Without Medicaid coverage, dental care will become too expensive and out of reach for many Americans, pushing people to emergency rooms and costing states millions," a spokesperson for CareQuest told Becker's. "This is deeply concerning especially given oral health’s direct connection to overall health, with links to conditions like high blood pressure, diabetes and adverse birth outcomes. Moreover, reducing Medicaid funding would widen health disparities, hitting low-income families the hardest. We urge Congress to protect Medicaid dental benefits and safeguard the health of millions of Americans."
Andrew Mintz, the CEO of The Smilist, told Becker's that cuts to Medicaid could hurt DSOs and other providers who are already struggling with low reimbursements. In addition to higher costs for treatment, Mr. Mintz is also concerned that cuts would exacerbate workforce shortages.
"DSOs, as well as any private practice, cannot survive seeing patients if they lose money every time a patient walks through the door," he said in an email to Becker's. "I’m concerned that either there will be a further shortage of providers who are willing to see Medicaid patients (creating other health issues for those patients who don’t have access to care) or that the quality of care will significantly decrease if the volume of patients needs to increase in order to keep the practice running."
Jason Korkus, DDS, the founder of Sonrisa Family Dental in Chicago, told Becker's that half of his practice's revenue comes from state managed care organizations funded by Medicaid. Despite being concerned about the possibility of cuts, Dr. Korkus said he is confident that he will not see a change in his patient base.
Dr. Korkus said his practice dealt with this issue before when former Illinois Gov. Pat Quinn cut the state's Medicaid dental budget in 2012.
"As worried as we were, our revenue remained the same and grew due to the fact that these patients became insured or self paid. I assume that the majority of our patient base will remain on the Medicaid plan because they would qualify in the range of 'need' per the cuts requirements," Dr. Korkus said. "I always say that if you provide great service, your business will never falter."
Allen Dorsey, DDS, is not as optimistic, adding that these cuts could cause practices and larger organizations to suffer if enacted.
"[These cuts] will cause major chains to suffer because they control most of the Medicaid dental benefits," he told Becker's. "[It could also cause] some bankruptcies for those dental clinics who depend on a greater percentage of their income gross from Medicaid."
The threat of these cuts has led to concerns that the House will not be able to pass the proposal, The Hill reported.
The House plans to vote on the budget proposal next week.