Gov. Healey Proposes $1K Cap on Adult Dental Benefits Under MassHealth

Massachusetts Gov. Maura Healey is proposing a $1,000 annual cap on MassHealth adult dental benefits as part of the FY2027 budget. Her goal with this proposal is to curb costs and mitigate potential federal funding losses.

Public health advocates and dentists strongly oppose the cap. They warn that it could reduce access to preventive and restorative care for approximately 2 million MassHealth enrollees and threaten the health of their practices.

If enacted, the cap would affect adults enrolled in MassHealth, while pediatric dental benefits would remain exempt.

According to a Sentinel & Enterprise report, Bay State residents with MassHealth are already experiencing challenges with finding quality dental care.

In 2021, the Massachusetts Health Policy Commission reported that approximately 45% of dentists statewide accept MassHealth. MassHealth spent about $270 million on adult dental services last fiscal year, according to health officials.

Health and Human Services Secretary Kiame Mahaniah said the proposal to cap MassHealth adult dental benefits at $1,000 each year is a “tough decision.” He noted that he's “very aware” that many Bay Staters would “exceed” the limit with the dental services they require. 

Mahaniah said that caps in other states range from $750 to $1,500 annually and stressed the need to balance service coverage with MassHealth's fiscal viability.

“The goal is, ‘How do we maintain the service for a majority of people while being able to sustain all of MassHealth and not swallow up the rest of the budget?'” Mahaniah explained to the Joint Committee on Ways and Means on Friday, March 27, in a statement shared with the Sentinel & Enterprise.

An online petition is currently circulating. It urges lawmakers to re-evaluate and to consider feedback from patients and dentists who are speaking out against the proposal.

“How can we reduce that amount without supporting basic preventative care and early intervention?” stated a signee named Allison, who did not provide her last name. “This limit is both shortsighted and disrespectful for those among us trying their hardest to get by.”