Session Updates

2026 Legislative Agenda

At its September 2025 meeting, the MDA Board of Trustees approved the following 2026 MDA Legislative agenda. Updates will be provided as the session begins. For now, we ask members to save the date to attend the 2026 Dental Day at the Capitol to advocate for these issues. It is Wednesday, March 4 in Jefferson City.  

DENTAL MEDICAL LOSS RATIO

  • Background: The Affordable Care Act (ACA) established that major medical plans pay certain percentages of the collected premiums for medical care vs. administrative costs. For example, large group plans must spend at least 85 percent of their collected premiums on care delivered to patients and no more than 15 percent can be spent on administrative costs and profit. No such requirement exists for dental plans which are considered “excepted benefits.” This legislation was filed in 2024 and 2025. It was referred to committee in 2025, but due to lack of data from other states, it failed to pass. 
  • Looking Ahead: In 2026, MDA will re-file the legislation. Our lobby team is currently working to identify bill sponsors and hopes to pre-file the legislation in December. The ADA has stated there should be good data coming from states who are enacting DLRs. 

ORAL PREVENTIVE ASSISTANT EFDA 

  • Background: In 2021, the MDA formed an exploratory workforce committee charged with investigating workforce shortages within Missouri’s dental community and possible solutions. One solution is a type of scaling dental assistant. The creation of this new health care role — the Oral Preventive Expanded Function Dental Assistant (OPA/OPA-EFDA) — must be done through the state’s dental practice laws. The rule was promulgated for the pilot project by the Missouri Dental Board and in March of this year, patients started to be seen through the clinical trial portion of the pilot. Data collection has been ongoing since then and a report to the Dental Board will be provided by the end of 2025. 
  • Looking Ahead: In 2026, MDA will continue to move forward with creating the OPA to be permanently placed into laws in the State of Missouri. 

APPROPRIATIONS 

  • Background: During the 2025 legislative session, through MDA advocacy, the following 2026 budget items were successful: increasing from $90,000 to $180,000 for Donated Dental Services; maintaining $400,000 for Elks Mobile Dental Services; maintaining the 2022 historic rate increase for Missouri Medicaid dental providers (80 percent of 50th percentile of UCR); increasing general Medical Anesthesia rates. 
  • Looking Ahead: We will continue our advocacy with the House and Senate budget committees to request maintaining funding for these dental items again in FY27.

2025 Session Recap

The 2025 Missouri Legislative Session ended May 16. Below is a summary of action on MDA priorities and legislation we were monitoring. You also can read a full end-of-session report prepared for the MDA by our lobby team at Gamble & Schlemeier. Contact Halie Payne for any questions. 

The 2025 Legislative Session officially ended May 16. The Missouri Legislature passed only 50 of the more than 3,000 policy bills filed — a mere 1.5 percent of legislation. The MDA saw some great appropriations items cross the finish line, while other priorities fell short due to the cooperation in the legislature breaking down during the last days, highlighted by a rare use of the “previous question” PQ motion in the Senate, leading to stalled legislation, tension and an early adjournment.

Due to some unresolved issues from the breakdown in the final week, Governor Kehoe called a special session June 2, primarily to address disaster relief from the recent tornado and storm damage, funding for the Chiefs and Royals stadium renovations and funding for various projects from across the state which failed to be passed in the last two weeks of the regular session.

Thank you to Jorgen Schlemeier, Nikki Strong and Grace Riley, with Gamble & Schlemeier (and the entire MDA lobby team), for representing the MDA in the halls of the Capitol for another successful legislative session. We look forward to a productive interim and getting priorities across the finish line in 2026.

MDA Priorities 

Dental Loss Ratio (DLR) — Representative Kent Haden filed HB 439 and Senator Jill Carter filed SB 680, which was referred to the Senate Committee on Insurance and Banking. This legislation would require the Medical Loss Ratio (MLR) to apply to dental plans in a manner similar to how it currently applies to medical plans. Key revisions from last session include excluding charitable contributions from the numerator when calculating the Dental Loss Ratio (DLR) and adding a penalty provision for delayed rebate payments to ensure timely compliance.

Looking Ahead: As more states adopt DLR requirements, we can demonstrate to lawmakers that these policies do not lead to higher premiums or cause insurers to exit the market. This evidence will help build support for further legislative action. You can educate yourself at this link, the campaign page MDA created.

Appropriations

  • Medicaid Reimbursement Rates: The increased reimbursement rates for Missouri dental Medicaid providers, originally implemented in 2022, have been maintained. Additionally, the FY26 budget includes an increase in reimbursement for general medical anesthesia codes to approximately 63% of the 50th percentile usual, customary, and reasonable (UCR) rate.
  • Elks Mobile Dental Services: Funding was increased for the Elks Mobile van to $600,000 in the FY25 budget. The Elks The Elks Mobile van provides dental services to those with developmental disabilities or intellectual disability populations.
  • Donated Dental Services: Funding for the Donated Dental Services Program was maintained at $180,000 in the FY26 budget.

MDA Monitored Legislation

Dentist and Dental Hygienist Licensure Compact — We are in support through collaboration of legislation to establish the Dentist and Dental Hygienist Licensure Compact, which would allow licensed dentists and dental hygienists to practice across state lines without additional licensure requirements. HB 56, sponsored by Representative Jeff Coleman, passed the House by a wide margin (140-8), while SB 327, sponsored by Senator Ben Brown, advanced through the Senate Committee on Emerging Issues and Professional Registration. The compact language was also added to several omnibus bills. One of which, SB 61, was taken up for a final vote but eventually laid over after a filibuster started over the possibility of a PQ motion on Proposition A and Amendment 3 legislation. Due to this rarely used procedure in the Senate, tensions rose creating a gridlock for other legislation, including SB61, killing the bill.

Looking Ahead: While the outcome was not what we wanted, this bill received ample support. Next year we are optimistic of the Compact’s passage, as more states enter the Compact and seeing as the bill faced little opposition this year.

Proposition A Repeal — HB 567 was passed through the Missouri Legislature and signed into law by Governor Mike Kehoe on July 10, effectively repealing the requirements of Proposition A, which was passed via ballot initiative in November 2024. The bill took effect on August 28, 2025. There are two key provisions of the bill affecting private sector employers (and thus, dentists).

  1. Repeal of Paid Sick Leave Mandate: The bill repeals RSMo 290.600 – 290.642, which currently requires the accrual of earned paid sick time for employees in Missouri.
  2. Amendments to the Minimum Wage Statute: The bill also amends Missouri’s minimum wage statute. Under Proposition A, minimum wage would be increased or decreased based on the Consumer Price Index. This adjustment was set to take effect on January 1, 2027, and be re-adjusted annually. This provision will still take effect, but the planned adjustments for 2027 and beyond were removed. On January 1, 2025, the minimum wage increased to $13.75 per hour. The next increase will take effect on January 1, 2026, raising the minimum wage to $15 per hour, after which there will be no more adjustments.

The Missouri Chamber of Commerce published an FAQ for best practices for business to consider as they navigate the Prop A repeal. It is always recommended to have legal counsel review your own office policies.