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After a four-year wait to see a dentist, her son suffered. With Medi-Cal cuts, the wait will be even longer
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After a four-year wait to see a dentist, her son suffered. With Medi-Cal cuts, the wait will be even longer
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Guest Commentary written by
Pat Hornbecker
Pat Hornbecker is a retired dental hygienist and disability rights advocate. She also is president of the board of directors of The Arc of California.
As a retired dental hygienist in the San Francisco Bay Area, I understand how oral health affects every other system in the body.
I also understand this issue as a mother.
My adult son, Joseph, is nonverbal and has a developmental disability. He relies on Medi-Cal Dental — also known as Denti-Cal — for his care. He lives on Supplemental Security Income, and private dental coverage is out of reach.
For years, our family has navigated a system that is stretched beyond its limits.
Joseph once waited four years to receive a basic cleaning and exam. By the time he was seen, he had multiple broken teeth, advanced gum recession and untreated decay. He ultimately endured eight extractions, nine fillings and restorative gum surgery. His recovery was painful and difficult.
He was told to return in a year, but it took more than two years to schedule that follow-up appointment. When he was finally seen again, he had developed an abscess requiring urgent treatment — two more teeth were removed and another filling placed.
This is what “access” looks like.
Joseph’s experience is not unique. As president of The Arc of California Board of Directors, I represent about 500,000 Californians with developmental disabilities and their families. We hear similar stories every day.
People wait months, sometimes years, for appointments. Many must drive hours to find a dentist who accepts Medi-Cal. For individuals who require sedation, as Joseph does, the number of available providers shrinks even further.
Waitlists for an initial assessment can stretch six months to a year. Treatment waitlists are prioritized by urgency, meaning “routine” care can be delayed for years. Preventive care becomes crisis care, and emergency rooms become the default dental provider.
Now Gov. Gavin Newsom has proposed cutting $1 billion from Medi-Cal Dental beginning July 1, 2026, unless the Legislature rejects the cuts in the May Revise of the 2026–27 budget.
About 15 million Californians rely on Medi-Cal Dental, so these cuts would impact more than people with disabilities. They would harm seniors, children and low-income families in general — people this program is designed to protect.
The budget proposal would reduce reimbursement rates to dentists by 40% to 80%. If that happens, more than half of Medi-Cal dentists say they would stop accepting these patients or significantly reduce services, a recent California Dental Association survey says.
Let that sink in. If we lose even half the dentists currently serving Medi-Cal patients, the consequences would be devastating. Losing providers will lengthen waitlists, delay treatment and worsen health outcomes.
Untreated dental disease does not remain isolated in the mouth. It contributes to infections, cardiovascular complications, diabetes management challenges and hospitalizations. When preventive care disappears, emergency care rises — and emergency rooms are far more expensive than routine dental visits.
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I’ve worked in dentistry for decades; I know prevention is the most cost-effective path forward. As a mother, I know the human cost of delay.
Joseph’s oral health has deteriorated because of prolonged gaps in care. Each delay has accelerated the loss of teeth and compromised his quality of life. No family should have to watch preventable dental disease unfold simply because there are not enough providers willing or able to participate in the system.
We can choose a different path. Lawmakers have an opportunity during the May Budget Revise to reject these cuts and preserve access to essential care.
California has long prided itself on protecting its most vulnerable residents. Slashing $1 billion from Medi-Cal Dental sends the opposite message. Protecting Medi-Cal Dental is not just a line item in a budget; it’s a commitment to public health, fiscal responsibility and basic human dignity.
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