Advocating for Patients and Providers: Bridging the Gap in Dental Healthcare

Feb 22

At the Patient Advocate Program, our mission is to ensure patients receive the dental care they deserve while also advocating for the needs of dental providers who face daily challenges navigating the complexities of the healthcare system. Recently, our founder, Shelbey Arevalo, was featured on ABC10 discussing the potential impact of federal Medicaid budget cuts on Medi-Cal dental coverage. In addition, she met with the California Dental Association (CDA) to provide real-world insight on legislative efforts that could improve patient access to benefits and provider reimbursement policies.

Fighting for Medi-Cal Dental Coverage

With Medicaid providing critical dental benefits to millions of low-income individuals, any federal funding cuts could severely limit access to preventive and restorative care. The House Budget Committee recently proposed $1.5 trillion in spending cuts, with the Energy and Commerce Committee tasked with reducing $880 billion—raising concerns that Medicaid programs could be significantly impacted.

If these cuts go into effect:

Millions of Americans could lose access to essential dental care.
Dental practices serving Medicaid patients may struggle to stay open.
Health disparities will widen, as underserved communities lose preventive care.

“We have worked so hard to improve access to dental care,” said Arevalo. “It would be a devastating setback if these benefits were taken away—not just for patients, but for providers who are committed to serving them.”

According to the American Dental Association (ADA), about one in three dentists in the U.S. treat Medicaid patients, yet reimbursement rates remain low. If Medicaid funding is reduced, the number of participating providers may shrink, making it even harder for patients to find care.

Key Legislative Efforts: What We’re Fighting For

During her meeting with the California Dental Association, Arevalo contributed valuable perspectives on the following bills that could positively impact the dental community:

Assembly Bill 371: Assignment of Benefits

Requires dental benefit plans to honor patients’ assignment of benefits requests, allowing payments to go directly to the provider.
Many insurers currently deny these requests for out of network providers, leading to financial barriers for both patients and dentists.

Network Adequacy Standards

Ensures that dental insurance networks meet higher standards, so patients aren’t forced to travel long distances for in-network care.
Unlike medical plans, dental networks lack strict provider availability requirements, leaving patients with limited choices.

Senate Bill 386: Virtual Credit Card Protections

Addresses the issue of virtual credit card payments, which impose high processing fees on dental providers.
This revised bill follows a previously vetoed 2024 bill, aiming to reduce administrative costs for dental offices.

Why This Matters for Patients and Providers

These proposed bills and funding changes have major implications for both patients and dental professionals:

🦷 For Patients:

Without Medicaid coverage, dental care could become unaffordable, leading to delayed treatment and preventable emergencies.
Oral health is directly linked to overall health—reducing access to care could contribute to conditions like heart disease, diabetes, and pregnancy complications.

🦷 For Dental Providers:

Low Medicaid reimbursement rates make it difficult for dental practices to stay financially sustainable.
If Medicaid cuts are enacted, some dental offices may be forced to stop accepting Medicaid patients, further limiting access to care.

How You Can Help

At the Patient Advocate Program, we believe that every patient deserves access to quality dental care, regardless of their financial situation. That’s why we are fighting to ensure Medicaid dental benefits remain intact and that legislative policies support both patients and providers.

How You Can Support the Cause:

✅ Stay informed about Medicaid and dental policy changes.
✅ Contact your legislators to express support for Medicaid funding and dental reforms.
✅ Share this article to spread awareness about the importance of protecting dental care access.
✅ If you or someone you know needs help navigating dental benefits, reach out to us!

Join Us in the Fight for Better Dental Care!

The Patient Advocate Program will continue working to bridge the gap between patients and providers, ensuring that access to care remains a priority. Stay tuned for updates on legislative efforts, Medicaid funding decisions, and how you can help protect the future of dental healthcare.

👉 Need advocacy support? Contact us today!
📩 Admin@PatientAdvocateProgram.org

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