Government Relations
the Senate for consideration. Sen. Jay Costa reintroduced his bill in the Senate, but the committee has not considered the bill and it is unclear which of the two bills will continue moving through the legislative process.
In other Medicaid-related news, the ADA Team took the summer to assess the impact the federal One Big Beautiful Bill( OBBB) Act will have on states’ Medicaid program. Most of the requirements will not take effect until 2026-2028, but they may impact whether the General Assembly will pass legislation to restore comprehensive dental coverage for adults. Key takeaways include:
• While still intact at present, the future of both pediatric and adult Medicaid dental benefits will vary by state due to budgetary constraints.
• All non-mandated dental services are subject to review as states’ ability to collect revenue changes. Pediatric dental Medicaid benefits are federally mandated as they fall under the Early and Pediatric Screening, Diagnosis, and Treatment( EPSDT) benefit. However, possible reductions in reimbursement may occur to offset budget cuts. States may re-evaluate their Medicaid benefits for adults, which are not mandated by the federal government.
• There are other provisions in the OBBB that states and stakeholders must consider: o Cap on state-directed payments( dental schools and university-affiliated clinics may be impacted). o Elimination of states’ ability to create or increase new provider taxes and a reduction of the state harbor for provider taxes from 6.0 % to 3.5 % for Affordable Care Act expansion states. o Cost-sharing for Medicaid beneficiaries at 100 %-138 % of federal poverty level will increase to $ 35 per visit. o Implementation of community engagement provision or work / school requirements for parents with children over 14 years of age. o Eligibility determinations every six months. Individuals who are no longer eligible for Medicaid are unable to use a Special Enrollment Period to enroll in health insurance through individual marketplace exchanges.
SEPTEMBER / OCTOBER 2025 | PENNSYLVANIA DENTAL JOURNAL 9