By JoAnn Volk and Tara Straw*

In the final 2025 Notice of Benefit and Payment Parameters, the Centers for Medicare & Medicaid Services (CMS) offered a new option for states to update their essential health benefits (EHB) benchmark plan to require coverage of routine adult dental benefits. Research has highlighted significant disparities in oral health outcomes for adults depending on their insurance status, race and income. For example, Black adults are twice as likely to have untreated dental caries as White adults. While there are multiple drivers of inequities in oral health, including limited access to dental providers, a primary barrier to accessing dental services is the cost of care, a barrier that can be reduced with dental insurance. 

In their latest Expert Perspective for the State Health & Value Strategies program, CHIR’s JoAnn Volk and Manatt Health’s Tara Straw provide an overview of the newly available flexibility and discuss considerations for states weighing whether to add a requirement that plans subject to EHB cover routine adult dental care.

You can read the full article here.

*Tara Straw is a Senior Advisor at Manatt Health.