Quick Take
Gov. Gavin Newsom’s plan to cut Medi-Cal dental benefits risks repeating California’s costly 2009 mistake, when preventable issues turned into medical emergencies, writes Laura Marcus, CEO of Dientes Community Dental Care. Marcus argues that the proposed budget savings would actually shift higher costs onto hospitals and vulnerable communities. Expanded dental coverage has improved health outcomes and access to care for thousands, she writes, but that progress is now at risk. She says lawmakers face a clear choice: protect preventive care or pay more later for crisis-driven treatment. The vote will happen by June 15.
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A few weeks ago, I stood before the California State Assembly Budget Subcommittee on Health not only as the CEO of Dientes Community Dental Care, but as a voice for our 18,000 patients in Santa Cruz County — who rely on Medi-Cal for essential dental care. My message was clear: Reject Gov. Gavin Newsom’s proposed cuts to Medi-Cal dental benefits. The consequences of repeating past mistakes are too great.
I am grateful to Assemblymember Dawn Addis, committee member Mia Bonta and Speaker Robert Rivas for their continued support of oral health care for California’s most vulnerable communities. Their leadership reflects what is truly at stake: not just a budget decision, but the health and dignity of millions. Within the next week, the Assembly and Senate health committees will hold hearings regarding the broader Health and Human Services (HHS) budget, and the final decision process will stretch into June.
At Dientes, we have seen what is possible when California invests in comprehensive care. When I began leading the organization in 2004, we served fewer than 7,000 patients, most receiving only minimal care — perhaps a cleaning or a filling. Today, thanks to the Affordable Care Act and Medi-Cal expansion, we serve 18,000 patients annually. They receive life-changing — and often life-saving — care: root canals that stop infections, dentures that restore the ability to eat and prenatal dental care that protects both mother and child. This is what a functioning safety net looks like.
Now, that progress is at risk.
The governor’s proposal would eliminate full-scope adult dental benefits for certain Medi-Cal enrollees based on immigration status and cut Proposition 56 supplemental payments that sustain dental providers. While framed as a $2 billion savings, these cuts would in reality shift costs elsewhere — onto hospital emergency rooms and communities already under strain.
We know this because we have seen it before.
In 2009, California eliminated adult Medi-Cal dental benefits. The results were immediate and severe. Preventive care disappeared. Patients delayed treatment until pain became unbearable. Dental infections escalated into medical emergencies. Emergency departments — already stretched thin — became the default providers for preventable dental conditions. This was not cost savings; it was cost deferral, and at a much higher price.
Today, we risk repeating that same pattern.
A 2025 analysis from the American Dental Association projects a $400 million loss over five years from eliminating benefits to the 1.5 million undocumented Californians on Medi-Cal, due to increased emergency visits, higher medical costs from untreated disease and job losses in the health care sector. These cuts will not save money — they will move costs into more expensive and less effective parts of the system.
While framed as a $2 billion savings, these cuts would in reality shift costs elsewhere — onto hospital emergency rooms and communities already under strain.
LAURA MARCUS
At the same time, reducing Proposition 56 funding threatens to unravel the already fragile provider network that serves Medi-Cal patients. Even now, access is limited: only 1 in 3 adults in our community can find a dentist who accepts Medi-Cal. Further reductions will push providers out of the system. Some large dental providers, like Western Dental, are already considering clinic closures. For many families, that would mean losing access to care altogether.
Dental care is not optional — it is essential health care.
Untreated oral disease worsens chronic conditions like diabetes and heart disease, complicates pregnancies and leads to avoidable pain and suffering. These impacts do not stay confined to the mouth; they ripple across the entire health care system, increasing costs for everyone.
We should be expanding access to care, not retreating from it.
I urge the legislature to reject these cuts, protect adult Medi-Cal dental benefits and preserve Proposition 56 funding. Revisions can occur until May 14, and June 15 is the last day the overall vote can occur. At a minimum, a one-year delay — made possible by stronger-than-expected state revenues — would give patients and providers critical time to prepare and avoid immediate harm.
California has already learned this lesson the hard way. We cannot afford to learn it again.
The choice before us is clear: invest in prevention and dignity or pay far more for crisis and neglect. For the health of our communities and the strength of our safety net, I urge lawmakers to choose wisely.
Laura Marcus is the CEO of Dientes Community Dental Care and a fierce advocate of oral health for all.