H.R. 9831 — Medicaid Dental Benefit Act of 2026

This section requires states to cover dental and oral health services for adults under Medicaid, including dentures, implants, and services to prevent disease, restore function, reduce pain, and treat emergencies, effective for calendar quarters beginning January 1, 2027. It applies the requirement to benchmark plans and the medically needy population, makes coverage optional for territories, permits states to cover additional related items and services at their option, and sets the federal medical assistance percentage at 100 percent for these services for a 12-quarter period beginning January 1, 2027 (or the first quarter of coverage in territories).

This section directs the Secretary of Health and Human Services to identify and publish a recommended core set of adult oral health quality and equity measures for Medicaid enrollees over age 21. It requires publication of recommended measures within one year of enactment (including specific metrics on utilization, emergency visits, caries and periodontitis screening, fluoride applications, periodontal maintenance, and denture needs), an initial core set within one year, standardized state reporting formats within two years (stratified by race, ethnicity, primary language, disability status, sexual orientation, and gender identity), annual state reports on quality and equity, and inclusion of related information in triennial reports to Congress.

This section directs the Medicaid and CHIP Payment and Access Commission to submit a report to Congress within 2 years of enactment on adult oral health issues across the 50 states, tribes, and territories. The report must address coverage availability and enrollment, oral health status among low-income women of childbearing age, access barriers for racially and ethnically diverse and limited-English-proficient communities, innovations to expand access beyond dental offices, and the effects of section 2 amendments with recommendations for improving Medicaid dental reimbursement rates.

This section directs the Secretary to develop, within one year of enactment, a program implemented through contracts with oral health care entities to provide culturally competent and linguistically appropriate information on Medicaid oral health and dental coverage for eligible adults; connect adults and underserved populations to such care; educate dental and medical professionals on core competencies for serving individuals with disabilities, pregnant and postpartum individuals, Alaska Native and American Indian populations, and urban, rural, and other underserved communities; and deliver interactive oral health education for racially and ethnically diverse Medicaid beneficiaries.