Connecticut General Assembly considers Medicaid dental coverage changes in 2025

Connecticut's Senate Bill 1299, introduced on February 13, 2025, aims to reshape Medicaid-covered dental care by implementing a new prior authorization requirement for nonemergency dental services. This legislative move is designed to streamline the approval process while capping annual payments for adult dental services at $1,000, excluding essential preventive care and medically necessary treatments like dentures.

The bill, referred to the Human Services Committee, seeks to address the rising costs and accessibility issues within the state's Medicaid dental program. By mandating prior authorization for most nonemergency services, lawmakers hope to ensure that only necessary procedures are funded, potentially reducing wasteful spending. However, this approach has sparked debates among dental professionals and patient advocates, who argue that it could hinder timely access to care for vulnerable populations.

Notably, the bill exempts certain preventive services, such as oral exams and cleanings, from the payment cap, which supporters argue is crucial for maintaining oral health and preventing more severe health issues down the line. Critics, however, worry that the new restrictions may lead to delays in care and increased out-of-pocket expenses for patients who require more extensive dental work.

As the bill progresses through the legislative process, its implications could significantly impact Connecticut's Medicaid recipients, particularly low-income adults who rely on these services. Experts suggest that if passed, the bill could set a precedent for similar reforms in other states, potentially reshaping how dental care is accessed and funded under Medicaid nationwide. The next steps will involve committee discussions and potential amendments as stakeholders weigh the balance between cost control and patient access to essential dental care.