H.R. 9831: Medicaid Dental Benefit Act of 2026

This bill would require Medicaid to cover a broader set of dental and oral health services for adults starting January 1, 2027. In general, it would make adult dental coverage a required part of Medicaid in the 50 states and the District of Columbia, rather than something states may choose to include or exclude. It would also treat some dental coverage in Medicaid managed-care benchmark plans the same way, beginning in 2027.

What services would be covered

The bill defines “dental and oral health services” broadly. Covered services would include:

• Dentures and denture-related services
• Dental implants and implant-related services
• Services needed to prevent oral disease
• Services to improve oral health
• Services to restore oral structures to health and function
• Services to reduce oral pain
• Services to treat emergency oral conditions

These services would have to be furnished by providers legally allowed to provide them under state law.

State flexibility for extra benefits

States would still be allowed to offer additional dental and oral health services beyond the minimum federal definition, at state option.

Federal funding changes

For the first 12 quarters starting January 1, 2027, the federal government would pay 100% of the cost for the new Medicaid dental and oral health services for the 50 states and the District of Columbia. For the U.S. territories listed in the bill, the federal government would also pay 100% for the first 12 quarters after each service is first covered there.

The bill also says these extra federal payments for the territories would not count against existing territorial Medicaid funding caps.

Reporting and quality measures

The bill would require the federal government to create a new set of adult oral health quality and equity measures. These would track things like:

• Use of oral health services
• Whether oral evaluations happen during or after medical visits
• Emergency room visits for non-traumatic dental problems
• Follow-up dental care after emergency visits, including during pregnancy
• Counseling to improve oral health
• Care involving general anesthesia or IV sedation when medically needed
• Screening and treatment for cavities and gum disease
• Need for extractions or dentures

States would have to report annually on their adult oral health measures, dental benefits, reimbursement limits, and efforts to reduce disparities. The federal government would make these reports public.

Studies, outreach, and education

The bill would also:

• Require a Medicaid and CHIP Payment and Access Commission report to Congress within 2 years on adult oral health coverage, access barriers, disparities, and reimbursement issues
• Create an oral health outreach and education program within 1 year to provide culturally and linguistically appropriate information about adult dental coverage and help connect people to care
• Train dental and medical professionals on culturally competent care for adults in Medicaid, including people with disabilities, pregnant and postpartum individuals, Native populations, and underserved communities

Funding for administration

The bill authorizes $10 million to carry out the new quality and reporting section.

Relevant Companies

• HUM — Humana could be affected through its Medicaid managed-care business and any dental-related benefit administration or provider network arrangements tied to state Medicaid plans.
• CNC — Centene could be affected because it operates Medicaid managed-care plans in many states, which may need to expand or adjust adult dental coverage and reporting.
• MOH — Molina Healthcare could be affected through changes to Medicaid benefit design, managed-care coverage, and related administrative requirements.
• ELV — Elevance Health could be affected in states where it serves Medicaid members and may need to adapt coverage, reporting, and provider reimbursement systems.
• UNH — UnitedHealth Group could be affected through its Medicaid managed-care operations and any dental benefits it administers for public programs.
• DK — Encompass Health? None directly; no likely significant direct impact found from the bill text.