President Trump’s “Big Beautiful Bill” includes more than $1 trillion in funding cuts for Medicaid over the next decade. For dental providers who accept Medicaid, the impact of these cuts is far-reaching.
What’s changing for dental practices?
The bill includes provisions that will affect how Medicaid is administered at both the federal and state levels. The most important changes for dental providers are:
- Work requirements for able-bodied adults without dependents, to be enforced by January 1, 2027
- Reductions in provider taxes and state-directed payments, beginning in 2028
- Imposed 80‑hour-per‑month work requirements on many adults receiving Medicaid, and applying existing SNAP work rules to additional beneficiaries.
- Stricter eligibility enforcement and documentation requirements rolling out over the next several years
The process for patients to enroll in and maintain Medicaid coverage will become harder for patients, and there will be fewer incentives for offices to accept Medicaid.
Expect more changes at the state level
Federal reform is just the beginning as states will be tasked with implementing these new guidelines. States will adjust their own Medicaid eligibility, documentation, and reimbursement policies. Practices that rely on Medicaid patients, especially those operating across state lines and in high-volume markets, need to prepare for change.
What this means for dental practices
More patients will risk loss of coverage: With work and eligibility requirements tightening, more patients will experience lapses in Medicaid coverage, increasing the risk of claim denials, payment delays, and confusion at the front desk.
There will be a higher administrative burden on staff: New documentation rules and fluctuating eligibility statuses will add complexity to insurance workflows that increase the time and effort of verifying coverage. What used to be a simple check could now include eligibility checks on multiple portals, confirming the patient’s current work status and hours worked, and more. Office admins could need retraining, and introducing new workflows increases the chance of costly errors that lead to denied claims.
There will be increased patient confusion and distrust: New work requirements and stricter enforcement of eligibility will increase the number of patients that show up thinking they’re covered, only to find out their plan is inactive. Without a proactive and accurate eligibility workflow, worst case this results in surprise billing, and best case the patient arrives at your office, only to be informed they do not have coverage. Unclear cost transparency and surprise billing can erode trust and lead to negative patient experiences.
Why accurate verification matters more than ever
With these Medicaid changes rolling out from 2026 to 2028, practices need to prepare for change and build out an insurance workflow that is more than just a simple eligibility check. They’ll need full visibility into:
- Deductibles and maximums
- Treatment frequency limits
- Dental home requirements
- Other insurance coverage conflicts
With a rise in Medicaid changes, even more patients will require clear cost estimates and transparency from their providers for them to receive care. Currently, nine out of 10 dental patients may delay general care due to cost concerns, and four out of five might postpone even emergency dental care.1
Practices that can verify eligibility accurately and provide out-of-pocket costs upfront and with confidence will not only improve patient trust and receive more visits, but they will also protect their revenue with better claim acceptance.
Why this all matters to dentists
The “Big Beautiful Bill” is a major shift for Medicaid dental providers. This new landscape will require comprehensive eligibility checks and proactive cost communication with patients. The reduction of incentives for practices that accept Medicaid means these practices will need to even further prioritize claim acceptance.
As states begin to adopt these new federal regulations, the need for smart streamlined insurance workflows that prevent claim rejections and improve the patient experience will only become more essential. The practices that adopt to these workflows will see even bigger and more beautiful returns.
Editor's note: This article appeared in the October 2025 print edition of RDH magazine. Dental hygienists in North America are eligible for a complimentary print subscription. Sign up here.
Reference
- Americans may forgo dental treatments due to cost, risking overall health, new Synchrony research reveals. PR Newswire. October 4, 2023. https://www.prnewswire.com/news-releases/americans-may-forgo-dental-treatments-due-to-cost-risking-overall-health-new-synchrony-research-reveals-301942034.html
