If the state cuts Medi-Cal, the wait for a dentist will be longer

By Pat Hornbecker, especially for CalMatters

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Guest Comment written by

As a retired dental hygienist in the San Francisco Bay Area, I understand how oral health affects every other system in the body.

I also understand this question as a mother.

My grown son, Joseph, is non-verbal and has developmental disabilities. He relies on Medi-Cal Dental — also known as Denti-Cal — for his care. He lives on Supplemental Security Income and private dental coverage is unaffordable.

For years, our family navigated a system that is stretched beyond its limits.

Joseph once waited four years to get a thorough cleaning and exam. By the time he was seen, he had multiple broken teeth, advanced gum recession and untreated tooth decay. Ultimately, he endured eight extractions, nine fillings and reconstructive gum surgery. His recovery was painful and difficult.

He was told to come back in a year, but it took more than two years to schedule that follow-up appointment. When he was finally seen again, he had developed an abscess requiring emergency treatment – two more teeth were extracted and another filling was placed.

This is what “access” looks like.

Joseph’s experience is not unique. As president of the Arc of California Board of Directors, I represent about 500,000 Californians with developmental disabilities and their families. We hear similar stories every day.

People wait months, sometimes years, for appointments. Many have to drive for hours to find a dentist who accepts Medi-Cal. For individuals who require sedation, as Joseph does, the number of available providers shrinks even further.

Waiting lists for initial assessment can stretch from six months to a year. Waiting lists for treatment are prioritized by urgency, meaning “routine” care can be delayed for years. Preventive care is becoming crisis care, and emergency departments are becoming the primary dental provider.

Now Governor Gavin Newsom has proposed cutting $1 billion from Medi-Cal Dental starting July 1, 2026unless the Legislature rejects the cuts in the May revision of the 2026-2027 budget.

About 15 million Californians rely on Medi-Cal Dental, so these cuts would affect more than people with disabilities. They would harm the elderly, children and low-income families in general – the very people this program is designed to protect.

The budget proposal would cut dentist reimbursement rates by 40% to 80%. If that happened, more than half of Medi-Cal dentists say they would stop seeing these patients or significantly reduce services, recently The California Dental Association study states.

If we lose even half the dentists currently serving Medi-Cal patients, the consequences will be devastating. Losing providers will lengthen waiting lists, delay treatment, and worsen health outcomes.

Untreated dental disease does not remain isolated in the mouth. It contributes to infections, cardiovascular complications, diabetes management challenges, and hospitalizations. When preventive care disappears, emergency care increases — and emergency rooms are much more expensive than routine visits to the dentist.

I have worked in dentistry for decades; I know that prevention is the most cost-effective way forward. As a mother, I know the human cost of delay.

Joseph’s oral health has deteriorated due to continued lapses in care. Any delay accelerates tooth loss and compromises his quality of life. No family should have to watch preventable dental disease develop simply because there are not enough providers willing or able to participate in the system.

We can choose a different path. Legislators have an opportunity during the Budget revision for May reject these cuts and preserve access to essential care.

California has long prided itself on protecting its most vulnerable residents. Cutting $1 billion from Medi-Cal Dental sends the opposite message. Medi-Cal Dental protection is not just a budget line; it is a commitment to public health, fiscal responsibility and basic human dignity.

This article was originally published on CalMatters and is republished under Creative Commons Attribution-NonCommercial-No Derivatives license.