The cuts to the MassHealth Dental Program benefits were the result of federal cuts to Medicaid.
Adult dental care provided to MassHealth recipients, which had been gradually increasing since 2013, is about to be limited to $1,750 annually on August 1, 2026.

Governor Maura Healey had proposed a $ 1,000 cap, but the House Ways and Means Committee increased the maximum annual benefit to $1,750 in the final budget proposal, to be confirmed by July 31st.

Federal healthcare funding reductions in Massachusetts of about $3.5 billion forced the cuts, and in spite of lobbying efforts by the Massachusetts Dental Society and Tufts Dental School, among others, the new restrictions will take effect and dramatically reduce the ability of low-income residents to even afford basic dental care such as crowns.

Previous reductions in adult dental care benefits in Massachusetts have resulted in more costly emergency room treatments when medically necessary care is ignored, and a letter from the Massachusetts Dental Society to Governor Healey in January warned that a similar negative impact on dental health could recur if MassHealth Dental benefits are cut.

According to the Massachusetts state website, which outlines the anticipated changes, adults enrolled in MassHealth Standard, MassHealth CommonHealth, MassHealth Family Assistance, or MassHealth CarePlus will receive dental coverage of up to $1,750 per year.

The changes will not affect residents who are adult clients of the Massachusetts Department of Developmental Services and over 21 years of age. Children enrolled in the MassHealth program are also not affected by the cuts.

Dental coverage for emergency services that put health in serious jeopardy, cause serious impairment to bodily functions, or cause serious dysfunction of any organ or part can be covered under MassHealth Limited. Other low-income residents who have coverage through the Health Safety Net will be affected by the $1,750 annual limit. If a dentist refers a patient to an oral surgeon for oral surgery, MassHealth may directly cover treatment.

The Massachusetts Legislature struggled with the issue of cuts to MassHealth Dental after several letters from the Massachusetts Dental Society (MDS), first following Governor Healey’s proposed $1,000 cap, and a second after the House’s $1,750 proposal went to the Senate for consideration. The Massachusetts House approved the $1,750 cap on April 15th, and nearly immediately on April 17th, the MDS President Steven Spitz, DMD, wrote to Senator Michael Rodrigues, Chairman of the Senate Committee on Ways and Means, to ask the Senate to increase the cap to $2,000.

The MDS also asked in their letter for the Senate to consider exemptions to the cap for preventive care, dentures, extractions, and medically or dentally necessary services. A petition initiated by MDS Past President, Dr. Abe Abdul, also promoted a higher cap. The MDS cited the cumulative effects of the cuts to MassHealth Dental in 2010, which were slowly reversed starting in 2013, but which left 100,000 residents without dental coverage. The resulting increase in dental disease is still being felt, the letter said.

In spite of the dental industry lobbying efforts, the State Senate approved their version of the budget without the proposed $2,000 cap and without exemptions. It remains to be seen how the low proportion of dentists who do accept MassHealth will handle these changes, which may require difficult decisions on what dental care is absolutely necessary to fit under the cap.

Brian Hatch
Hatch Legal Group
8 North Main Street, Suite 403
Attleboro, MA 02703
HatchLegalGroup.com
brianhatch@hatchlawoffices.com
508-222-6400