WALTHAM, MASS. — Gov. Maura Healey’s new budget proposal for fiscal year 2027 includes a big change to MassHealth dental coverage with a $1,000 annual cap.
State officials say it’s about controlling rising healthcare costs, but patients and dentists warn it could mean fewer people getting the care they need.
Under the budget proposal, adult MassHealth dental coverage would be capped at $1,000 a year.
Currently there’s no annual cap but there are other limitations like prior authorization, repayment reviews, and frequency limitations.
Dentists like Dr. Haroutious Kotchinian are sounding the alarm saying that annual amount would barely cover a single crown. The co-owner of Koko Dental Care in Waltham says that would leave little to nothing for cleanings, fillings, or follow-up care.
“For our patients that have MassHealth, often times they’re not walking around with one problem. Usually, they have multiple so that $1000 cap would be asking them to choose one tooth over another,” Dr. Kotchinian said.
According to state officials, during fiscal year 2025, MassHealth spent about $270M on adult dental services and say costs are rising rapidly across the entire healthcare sector.
They add that MassHealth spending is being driven by the same trends affecting commercial insurance, including a sharp increase in the cost of providing care.
However, patients like Mikayla Gilcrest who rely on MassHealth worry the change could force them to delay or skip care altogether.
“I’m worried for myself and everyone else that potentially needs to have work done. It sucks especially with everything being the way it is right now. Not very many people have extra money to spend on stuff like dental care,” Gilcrest said.
State officials are also pointing to looming federal cuts tied to the One Beautiful Bill Act, saying once fully implemented, Massachusetts could lose about $3.5B a year in federal healthcare funding.
The state says the proposed cap is a “measured step” meant to control cost growth while maintaining coverage; estimating the change could save the state up to $120M.
Still, dentists warn that limiting coverage could lead to worse, and more expensive health problems down the line.
“Working with MassHealth for the last 4-5 years, I’ve been able to do some of the most meaningful work for patients. I’ve been able to see people fix their teeth, get job interviews, see their loved ones with just tears coming down so it’s been very meaningful work and to see that kind of disappear in the blink of an eye felt like it’s something worth fighting for,” Dr. Kotchinian said.
There is an ongoing petition fighting against the cap as the proposal is now in the hands of lawmakers who will decide whether the cap stays in the final budget.
This is a developing story. Check back for updates as more information becomes available.
Download the FREE Boston 25 News app for breaking news alerts.
Follow Boston 25 News on Facebook and Twitter. | Watch Boston 25 News NOW