California is expected to cut Medi-Cal dental coverage for an estimated 2 million immigrants on July 1, 2026. Adult immigrants who receive state-only funded Medi-Cal will lose full scope dental benefits and will only have access to emergency dental care. Pregnant persons are exempt from these cuts during their pregnancy and 12 months after their pregnancy ends. Impacted enrollees will lose coverage for routine dental exams and other preventative and specialty treatments. Cutting adult dental benefits for millions of immigrants is not sound policy as any cost savings for the state will likely be eliminated by individuals with unmet dental needs forced to delay care until dental problems become emergencies that are more difficult and more expensive to treat. It will also force these immigrants to choose between forgoing treatment or incurring medical debt, further destabilizing their economic security.
California should abandon these cuts and continue building upon its previous health care expansion to provide comprehensive Medi-Cal coverage to all Californians regardless of immigration status. The state’s historic expansion recognizes the humane and cost-effective value of preventative health while also minimizing the financial strain on individuals and the health system. It is especially important to protect the dignity and health rights of immigrants given the federal administration’s unrelenting attacks on these principles that are experienced by Medi-Cal enrollees across the state.
Dental cuts against immigrants will shift costs rather than save costs
Research repeatedly shows that cuts to preventative care result in long-term cost increases. Dental cuts for certain adult immigrants will shift burdens to other parts of the health care system — costly emergency room visits will increase, local governments will absorb more costs, and immigrant patients will experience worse health outcomes. Depleting the state’s preventative care system will shift costs to different settings in the short-term and likely increase long-term costs.
Fifteen years ago, California cut Medi-Cal dental care for adults which resulted in these predictable outcomes. Research found that the state’s cuts to adult Medi-Cal dental care in 2009 drastically increased emergency department dental visits. Increased emergency visits raised the costs by 68 percent. The study also found that the quality of care decreased through emergency dental services because emergency personnel were generally not equipped or trained to treat dental diseases effectively.
Added pressure will be placed on counties and local governments, who are often tasked, and sometimes legally required, to address health coverage gaps for uninsured or low-income individuals. However, such resources are limited, especially by county. Counties will have to weigh tradeoffs and consider slashing critical safety net programs elsewhere. Uncompensated care costs for hospitals and clinics will also likely increase at a time when they can least afford it.
Further, low-income populations are affected by cuts to health services differently. Various health disparities emerged after California’s 2009 dental cuts, with lower income families and communities of color experiencing the most harmful effects. California’s decision to specifically targets certain immigrants amid heightened immigration enforcement and other cuts to life-sustaining public benefits will deepen those harms.
Health care cuts often come at the time of highest need — individuals, families, and communities undergoing economic strain need the state’s support now more than ever. Immigrant communities especially need this support given the federal administration’s normalization of constitutional violations and assaults on human dignity and access to basic necessities. Cutting dental care to millions of adult immigrants will only worsen the current situation. California must right this wrong and instead consider long-term, sustainable revenue solutions that build upon its goal to provide affordable health care to all Californians regardless of immigration status. It is not too late for California to do the right thing and continue dental care for immigrants as a sound policy decision that will be more humane and cost effective in the long run.
