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2025 Legislative Priorities

Discover the Connecticut Oral Health Initiative's legislative priorities and how we're advocating for policies that ensure equitable access to quality oral health care for all residents. Our priorities focus on expanding Medicaid coverage, increasing access to preventive care, supporting workforce development, and addressing oral health disparities caused by structural and social inequities.

Our Policy Agenda

  • Expand adult Medicaid by excluding preventive services, such as cleanings and oral exams, from the annual $1K benefit cap to improve access and utilization of care. Increase coverage to include periodontal treatment and a second-annual dental cleaning for all adult enrollees. Additionally, raise adult Medicaid reimbursement fee-for-service rates for preventive dental services to prevailing average commercial rates to incentivize provider participation and improve appointment availability.

    •  Expanding adult Medicaid to exclude preventive services from the annual benefit cap, while also increasing coverage for periodontal treatments and a second annual cleaning, helps address health disparities by ensuring more equitable access to essential dental care. This approach improves long-term health outcomes for underserved populations, fosters a more inclusive healthcare system by incentivizing provider participation, and ultimately benefits both individuals and the broader community. Additionally, it saves Medicaid state dollars by reducing the need for more expensive restorative care and spares individuals from unnecessary pain and suffering.

 

  • Enhance children’s oral health; by increasing Medicaid reimbursement rates for preventive services such as dental sealants and fluoride varnish treatments, expanding the Access for Baby Care Program to older children, and providing Medicaid dental benefits to all Connecticut residents who are income eligible up to age 21, regardless of immigration status.

    • Investing in preventive services will incentivize providers to increase access and appointment availability, ultimately saving Medicaid dollars by reducing the need for expensive restorative treatments.

    • Expanding the Access for Baby Care (ABC) Program to include all children up to the age of  21(currently available to children under the age of seven). Will ensure that every child receives oral health assessments and fluoride varnish treatments during well-child medical visits and connect them to follow-up dental care.

    • Expanding services to include all children in Connecticut, regardless of immigration status, ensures equitable access to care for everyone, and children already living in the state are provided oral health services which can greatly impact their overall health if not properly addressed. 

 

  • Improving services for Individuals with Intellectual and Developmental Disabilities by providing additional resources to providers for care coordination and improved training.

    • Providing additional resources for care coordination is essential to ensure equitable healthcare access for individuals with IDD. Adequate reimbursement rates are necessary to cover the extra time and effort required to meet the unique needs of these patients, addressing financial challenges and fostering a more inclusive healthcare system.

    • Investing in training for healthcare professionals will improve their ability to manage complex IDD cases, leading to more effective and compassionate care. This approach not only enhances health outcomes but also reduces hospitalizations and emergency visits by addressing issues early, supporting a more inclusive and accessible healthcare environment.

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  • Advocate for a medical loss ratio(MLR); to increase the allocation of dental insurance premiums toward direct patient care. 

    • Implementing a stronger Medical Loss Ratio (MLR) for dental insurance will ensure that a greater portion of premiums directly benefits patients, improving access to essential care and promoting better oral health outcomes for all residents.

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  • Address the growing workforce shortage in oral health care, especially in public health settings, by supporting solutions that expand access to qualified providers, including the integration of dental therapists. Dental therapists, trained and certified under federal standards established by the Commission on Dental Accreditation (CODA), can help fill critical gaps in care. This approach ensures patients receive timely and effective treatment, particularly in underserved areas, while maintaining high standards of quality in the dental care system.

    • Without action, the workforce shortage will continue to limit access to essential care, exacerbating oral health disparities and leaving many communities without the services they need.

 

  • Defend against any movement to change laws and regulations to reduce Connecticut’s Community Water Fluoridation Policy.

    • Extensive research has consistently shown that water fluoridation is a safe and effective method for improving oral health in communities. Since 1965, Connecticut has mandated that communities serving more than 20,000 residents adjust fluoride levels in drinking water to meet national best practices. This regulation helps maintain fluoride levels within a range that effectively prevents tooth decay, promotes oral health for individuals of all ages, and lowers overall healthcare costs. As one of the most practical and cost-efficient public health measures, fluoridation is vital in enhancing oral health and reducing disparities in access to care.

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  • Adding adult oral health benefits as designated essential health benefits (EHBs) required to be covered by health plans under the Affordable Care Act (ACA) by updating the Connecticut benchmark plan to specify its inclusion.

    • Federal policymakers, for the first time, have allowed states to add adult dental as an EHB. It is an important step toward improving health outcomes, reducing health and economic inequities, and opening access to oral health care for thousands of people in Connecticut.

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  • Defend against a change in Connecticut state policy from the current HUSKY Health managed fee-for-service program to a managed care Medicaid program.

    • Connecticut’s previously used managed care Medicaid program did not provide better care for Medicaid enrollees and lacked cost-effectiveness and transparency.

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Get the Summary

Board edits - COHI LEAD Program Flyer 20

Connecticut Oral Health Initiative, Inc.

53 Oak Street

Hartford, CT 06106

info@ctoralhealth.org

(860) 246-2644

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EIN - 52-2380576

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© 2018 by COHI, Inc.

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