A new Harvard School of Dental Medicine study, published June 18, 2026 in JAMA Network Open, projects that federal Medicaid changes could cause roughly 480,000 U.S. children to lose dental coverage each year through 2034, leading to an estimated 95,799 additional cases of untreated tooth decay and nearly 87 million dollars in added downstream health costs. The coverage losses stem from new work reporting requirements tied to the One Big Beautiful Bill Act, which researchers say will pull eligible children off Medicaid even though the rules target adults. For families who rely on Medicaid to keep their kids cavity free, the message is to confirm coverage now and schedule needed care before any gaps open.
What did the Harvard study actually find?
The study found that Medicaid disenrollment among low income children could produce large, measurable harm to their teeth within a decade. Using decision analytic modeling built on data from about 12,000 children, researchers at the Harvard School of Dental Medicine estimated that roughly 480,000 children would lose coverage annually through 2034, that this would drive 95,799 additional cases of tooth decay, and that the shift would add close to 87 million dollars in health care costs rather than eliminate them.
Key facts and figures
- About 480,000 children could lose Medicaid dental coverage each year through 2034 (Harvard School of Dental Medicine, JAMA Network Open, 2026).
- An estimated 95,799 additional cases of tooth decay are projected over 10 years (Harvard School of Dental Medicine, 2026).
- Nearly 87 million dollars in added downstream health costs are projected from delayed treatment (Harvard School of Dental Medicine, 2026).
- The One Big Beautiful Bill Act is projected to cut federal Medicaid spending by more than 900 billion dollars over a decade (KFF Health News, 2026).
- About 41 percent of dentists participated in Medicaid as of 2024 (KFF Health News, ADA Health Policy Institute, 2024).
Why would children lose coverage if the new rules target adults?
Children can fall off Medicaid because of paperwork friction, not because they lose eligibility. The new work reporting requirements ask adults to document employment or exemptions to stay enrolled, and when a parent loses coverage or misses a filing deadline, the children in that household frequently drop off at the same time. Researchers call this the churn effect, and it is a well documented reason that eligible kids end up uninsured even when the law does not remove their benefit directly.
Federal law still requires state Medicaid programs to cover dental care for enrolled children through the Early and Periodic Screening, Diagnostic, and Treatment benefit. The risk highlighted by the Harvard team is that children never receive that protected benefit if administrative barriers keep them from being enrolled in the first place.
How many families depend on Medicaid for dental care?
Medicaid is one of the largest payers of children's dental care in the country, and adult coverage has been expanding too. According to KFF Health News, 38 states plus Washington, D.C. now offer enhanced dental benefits to adults on Medicaid, and 18 states have added or expanded adult coverage since 2021. At the same time, dental access remains uneven: fewer than one in four adults on Medicaid in several sampled states saw a dentist in the past year, compared with 50 to 60 percent of adults with private insurance.
Coverage snapshot: what the study and reporting show
| Measure | Figure | Source and year |
|---|---|---|
| Children projected to lose coverage per year | About 480,000 | Harvard School of Dental Medicine, JAMA Network Open, 2026 |
| Additional tooth decay cases over 10 years | 95,799 | Harvard School of Dental Medicine, 2026 |
| Added downstream health costs | Nearly 87 million dollars | Harvard School of Dental Medicine, 2026 |
| Projected federal Medicaid spending cut over 10 years | More than 900 billion dollars | KFF Health News, 2026 |
| States plus D.C. offering enhanced adult dental benefits | 38 plus D.C. | KFF Health News, 2026 |
What are experts saying about the shift?
Researchers emphasize that dropping coverage does not lower the true cost of care, it just moves the bill to families and to emergency settings later. The study's lead author framed the stakes in plain terms.
"Coverage loss doesn't make costs disappear, it shifts them. Children who lose Medicaid don't stop getting cavities; they stop getting treated early." Dr. Sung Eun Choi, Assistant Professor of Oral Health Policy and Epidemiology at the Harvard School of Dental Medicine and lead author of the study.
What does this mean for families right now?
For most families, the practical takeaway is to treat 2026 as a year to stay ahead of coverage paperwork and preventive visits. Early care matters because a small cavity caught at a routine checkup is far cheaper and less painful to treat than an abscess that lands a child in the emergency room. Preventive tools such as fluoride varnish and dental sealants remain some of the highest value steps a family can take, which is one reason our recent guide on back to school dental checkups in 2026 encouraged parents to book the visit early.
If you are unsure whether your child's Medicaid coverage is active, a local practice can often help you verify benefits and plan care around your renewal date. Family and pediatric offices listed on Smilelisting, such as Hurst Pediatric Dentistry in Hurst, Texas, focus on preventive care for kids and can be a starting point for scheduling a checkup while coverage is confirmed.
What can parents do to protect their child's coverage?
Parents can take several concrete steps to reduce the chance of a coverage gap. Update your contact information with your state Medicaid agency so renewal notices reach you, respond quickly to any request for documents, and ask your dentist's front desk to confirm eligibility before each appointment. If your family does lose Medicaid, ask whether the practice offers a membership or sliding scale plan, and check whether your child qualifies for the Children's Health Insurance Program, which covers dental care in every state.
Frequently asked questions
Are children's dental benefits being cut directly by the new law?
No. Federal law still requires Medicaid to cover dental care for enrolled children. The concern is that new adult work reporting requirements will cause eligible children to lose enrollment through paperwork churn, which removes their access to that protected benefit.
How many children could be affected?
The Harvard School of Dental Medicine study projects that about 480,000 children could lose dental coverage each year through 2034, contributing to an estimated 95,799 extra cases of tooth decay over a decade.
What should I do if I am worried about losing coverage?
Confirm that your state Medicaid agency has your current address, respond promptly to renewal notices, and schedule any needed dental care sooner rather than later. If coverage lapses, ask about the Children's Health Insurance Program and about in office membership plans.
Where was this study published?
The study was published on June 18, 2026 in JAMA Network Open by researchers at the Harvard School of Dental Medicine.
Updated July 2026.
