More dentists will have to start participating in the state’s Medicaid program if every adult is going to get new oral health coverage. That’s the conclusion of TennCare advocates who found that fewer than one in three dentists in Tennessee accept the lower rates paid by Medicaid.

Gov. Bill Lee has put the money in his budget to expand dental benefits to everybody on TennCare. It also includes money to help incentivize dentists to open offices in underserved communities. But that doesn’t necessarily fix the problem of so few dentists taking Medicaid patients.

“There’s not enough to even see the children who have been able to go with their Medicaid insurance and get dental benefits,” says Kinika Young, senior policy director of the Tennessee Justice Center. “So we need more providers to step up.”

A TJC policy brief published in January finds that 30% of Tennessee dentists take Medicaid. And only about half of the children on Medicaid in Tennessee went to see a dentist in 2019.

A common complaint among dentists is that low-income patients are more likely to miss appointments. But Young says that’s why dentists need to learn how to better serve them, like offering extended hours and flexible scheduling.

Dentists have said the state’s Medicaid program, known as TennCare, must raise its rates. And Young agrees. According to a national analysis by Milliman consulting firm, the rates are usually less than half of what private insurance pays.