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Bill

A 5047

Establishes "Oral Health Equity Act."

2026-2027 Regular Session Introduced by Verlina Reynolds-Jackson and 1 co-sponsor

New Jersey creates an Oral Health Equity Program to expand access for uninsured/underinsured in underserved areas, with centers providing comprehensive care and FQHC-rate reimburse

Introduced, Referred to Assembly Health Committee
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Bill Summary · A 5047

Summary of Bill A 5047 (Session 222) – Oral Health Equity Act (New Jersey)

Purpose and intent

  • Establishes the “Oral Health Equity Act” to improve access to dental care for uninsured and underinsured residents, particularly in medically underserved areas.
  • Aims to reduce disparities in oral health outcomes and address gaps caused by low reimbursement rates under existing Medicaid/NJ FamilyCare programs.

Key provisions and changes

  • Housekeeping and definitions

    • Creates definitions for use in the act, including:
    • Community oral health center: in-state entity type eligible to participate (federally qualified health centers, dental homes, or acute care hospitals licensed by the Department of Health) that provide dental services to uninsured/underinsured residents in medically underserved areas.
    • Dental home: licensed dental practice that is accessible, culturally sensitive, and family-centered; excludes practices where fewer than 75% of patients are low-income and from medically underserved areas.
    • Medically underserved area: area designated by HRSA with limited primary care, higher infant mortality and poverty, and higher elderly population share.
    • Low-income: gross annual household income < 300% of the federal poverty level.
    • Uninsured: lives below poverty level and not eligible for Medicaid or NJ FamilyCare.
    • Underinsured: eligible for Medicaid or NJ FamilyCare services.
    • Medicaid and NJ FamilyCare: defined by existing New Jersey statutes.

  • Establishment of the oral health equity program

    • The Department of Human Services (the department) shall establish an oral health equity program via agreements with community oral health centers.
    • Participation requires an application to be filed with the department (process to be determined by the department).
    • Eligible centers must sign an agreement to provide dental care to underinsured and uninsured patients, including: 1) Initial visit: comprehensive exam, cleaning, caries risk assessment, periodontal charting, and a one-year treatment plan. 2) Comprehensive dental care and restorative treatment as needed. 3) Cleaning and treatment plan reviews at about six months and one year after the initial visit. 4) Two dental visits per patient annually. 5) Identification of a dental home for the patient. 6) Reimbursement to participating centers at a rate equal to or greater than the rate for similar services under federally qualified health centers (FQHCs).
    • Within 90 days after enactment, each participating center must compile and report relevant data to the department (data elements to be determined by the department).

  • Medicaid waivers and federal funding

    • The Commissioner of Human Services shall seek any necessary Medicaid waivers or State plan amendments to implement the act and to secure federal financial reimbursements for state expenditures.

  • Regulatory framework

    • The Commissioner shall adopt rules and regulations under the Administrative Procedure Act to effectuate the act.

  • Effective date

    • The act takes effect 90 days after enactment.

Who would be affected

  • Primary beneficiaries: uninsured and underinsured residents, especially those in medically underserved areas, who would receive expanded dental care through participating community oral health centers.
  • Participating entities: community oral health centers (including FQHCs, dental homes, and certain hospitals) that meet criteria and enter into department agreements.
  • State agencies: Department of Human Services, which administers the program, data reporting, and regulatory development; potential involvement of Medicaid staff for waivers and amendments.

Procedural and timeline aspects

  • Initiation and participation

    • Centers must apply to participate; department determines eligibility and enters into service agreements.
    • Data reporting obligation begins within 90 days after enactment.

  • Funding and reimbursement

    • Requires securing federal Medicaid waivers or state plan amendments to enable funding and ensure reimbursement parity with FQHC rates for comparable services.

  • Oversight and implementation

    • Department to establish program regulations; rules to be published under the Administrative Procedure Act.

Potential impact and considerations

  • Access and equity: targets improved access to preventive and restorative dental care for low-income, uninsured, and underinsured populations, particularly in medically underserved areas.
  • Quality and continuity: promotes establishment of dental homes and structured care plans with ongoing follow-up and regular visits.
  • Financial alignment: seeks reimbursement at or above FQHC rates to incentivize participation and sustainability of community centers.
  • Data and accountability: requires baseline data reporting to monitor program performance and outcomes.

Note: The sponsor indicates a rationale focusing on disparities in New Jersey’s oral health outcomes and the need to bolster access, particularly for Black and Hispanic children from low-income families, by expanding provider availability and improving reimbursement structures.

Compiled from official sources — confirm details with the bill’s official record.

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