2025 Legislative Priorities
During the 2025 legislative session, your IDA advocacy team will focus on three main issues: dental insurance reform, increasing dental Medicaid rates, and the dental workforce shortage.
Increase Medicaid Reimbursement
Dental Medicaid rates in Iowa make it difficult for dentists to continue seeing Iowans on the program. With Medicaid rates around 25 to 30 cents on the dollar for care provided, dentists are starting to make the difficult decision to leave the program. However, our efforts over the last few years have raised the profile of the dental Medicaid issue dramatically at the Statehouse. Dental Medicaid is one of the most discussed topics of the Health and Human Services budget in both chambers. We are encouraged by the momentum we built around this issue and are determined to make progress during next session.
Dental Insurance Reform
IDA is looking to build on our success in passing our first dental insurance reform since 2010, in 2024. We know insurance issues continue to be a hurdle in treating your patients and managing your practice.
We are looking at the following three issues for 2025:
Retroactive Denial of Coverage: Dental plans have the ability to review claims after payment has been delivered to dentists and request claim payment refunds under certain circumstances. The laws below restrict the timeframe in which insurers are allowed to request such a refund.
Prior Authorization Payments: Prohibits insurers from denying claims for procedures included in a prior authorization unless certain situations are present, such as when a patient has exceeded annual maximum or their dental condition has changed considerably since the authorization.
ERISA Notification Laws: Require insurance companies to include an indication of whether the health benefit plan is a fully insured (state regulated) or self-funded (federally regulated) plan (i.e., whether the state’s dental insurance laws would apply to a patient’s dental plan or not).
Improve the Dental Workforce
The urgent need for a stronger dental hygiene and dental assisting workforce is important to dentists and patients. A recent IDA survey found that 75 percent of respondents were experiencing a shortage of hygienists, assistants, or both in their offices. We are looking for opportunities for additional investment to expand existing programs , including Iowa Workforce Development's apprenticeship programs. The IDA Board has also formed a workforce committee to explore the workforce issue and potential solutions further.
In the News
- Crisis throughout the state': Local Medicaid recipients struggle to find dental care- Telegraph Herald 1/10/24
- Dental dilemma: Dearth of Siouxland dentists taking on new Medicaid patients - Sioux City Journal 7/5/2023
- Reps share concerns at Ernst Hope Haven visit - NWestiowa.com 7/3/2023
- Fully fund Medicaid in Iowa -Rep. Dr. Steven Bradley in The Gazette 8/18/2022
- Boost Funding for Dental Medicaid in Iowa -IDA Medicaid Committee Chair Dr. Sara Stuefen in The Gazette 2/28/2022
- Iowa Should Raise Its Medicaid Dental Reimbursements -IDA Member Dr. Brian Kim in the Quad-City Times 2/24/2022
- Dental Clinic Serving Low-Income Patients Expanding in Cedar Rapids -Eastern Iowa Health Center Dental Clinic in The Gazette 2/22/2022
- Let Iowa Dentists Help More Medicaid Recipients by Increasing Rates -IDA President Dr. Zach Kouri in the Des Moines Register 2/21/2022
- Fund Dental Medicaid Program -IDA Waterloo District Trustee Dr. Mike Stufflebeam in the Times-Republican 2/18/2022
- It Is Time Iowa Increases Dental Medicaid Rates -IDA President Dr. Zach Kouri in The Iowa Standard 2/15/2022
- Local Dentists Provide Free Services for Children During Give Kids a Smile -I-Smile Dental Home Initiative in The Daily Nonpareil 2/5/2022