NC Sen.sGale Adcock (D-Wake), Jim Burgin (R-Harnett) and Kevin Corbin (R- Macon) filed a bill to increase Medicaid payments to dentists. The senators, dentists, and other supporters spoke at a news conference on April 21, 2026. (Photo: Lynn Bonner/NC Newsline)
One of the reasons some children and adults who use Medicaid in North Carolina have rotting teeth is because they can’t find dentists who will accept their insurance.
State Medicaid payment rates for dentists haven’t changed since 2008. Dentists and some state senators say it’s long past time for increases.
“Children are living with pain,” said Crystal Adams, director of the N.C. Oral Health Collaborative. “Adults are unable to find employment because of their oral health. That should not be the reality in our state.” North Carolina’s Medicaid reimbursement rates rank in the bottom third nationally, she said.
Adams spoke at a news conference Tuesday about increasing payments to dentists as a way to improve Medicaid beneficiaries’ access to oral healthcare.
State Sens. Gale Adcock (D-Wake), Jim Burgin (R-Harnett) and Kevin Corbin (R-Macon) introduced a bill Tuesday that would appropriate an additional $80 million to Medicaid reimbursements for dentists. The increase would bring Medicaid reimbursement rates from 34% of commercial rates to 50%.
It’s critical to “understand and acknowledge that it’s impossible to be healthy without adequate attention to oral health,” Adcock said.”Surveillance and screening, preventive measures like cleanings, fluoride applications and sealants, and timely interventions like fillings, restorations, and extractions all contribute to overall health.”
Dentists say they lose money treating Medicaid patients.
Most dentists don’t accept patients who use Medicaid. According to a 2024 report prepared under the auspices of the N.C. Institute of Medicine, only about 40% to 45% of active licensed dentists participate in the Medicaid dental program. Many don’t accept new patients. In 2022, dental procedures comprised 14% of services to Medicaid beneficiaries, but payments to dental providers accounted for only around 2% of Medicaid spending.
Low payment rates combined with the challenge of finding dentists in some rural counties means people in those areas are even more likely to go without needed care, resulting in unfilled cavities and worse, said Dr. Frank Courts, a pediatric dentist. He called it a “crisis.”
NC doesn’t pay dentists enough to treat Medicaid beneficiaries, new report says
“Without this care, the cost of treatment becomes dramatically higher, and the health outcomes become much worse,” Courts said. “Poor oral health is a significant risk factor in cardiac conditions, diabetes, dementia, and a myriad of other medical conditions. Oral health is general health. Without oral health, you’re not going to have a healthy body.”
Kristen Jarrell, a foster parent who lives in Alexander County, told of the struggles she’s had finding dental care for foster children.
“We need more providers who can afford to accept Medicaid,” she said. “We need reimbursement rates that replace actual costs of care, so dentists can say ‘yes’ to these kids. Because right now, there are too many saying ‘no.’”
The call for increased payments to dentists comes as the increase in existing Medicaid costs became a point of contention between Gov. Josh Stein and the Republican legislature. Stein had been pushing legislators since last year to appropriate an additional $319 million to fill a funding gap as the state Department of Health and Human Services warned the program was about to run out of money.
House and Senate Republicans were unable last year to agree on a bill giving Medicaid more money. It was only Tuesday that Republicans said they are ready to provide the funds.
Despite the current strife over Medicaid costs, Adcock said it’s still important to highlight inadequate dental rates.
Advocates talked for years about Medicaid expansion before the legislature approved it, she said.
“What we know is that there’s never a perfect time to do this,” Adcock said. “We’re going to continue to ask for this until such time that it becomes reality, because here’s what we believe: everything looks impossible until it becomes inevitable.”
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