Matt Steele, Director of State and Local Advocacy at CareQuest

Summary

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Podcast Summary

Podcast: Becker’s Healthcare Podcast
Episode: Matt Steele, Director of State and Local Advocacy at CareQuest
Date: September 13, 2025
Host: Ariana Portolatten

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Episode Overview

This episode features Matt Steele, Director of State and Local Advocacy at CareQuest Institute for Oral Health, discussing urgent issues facing the dental industry. The conversation focuses on two major policy topics: looming Medicaid cuts and the national debate about community water fluoridation. Steele also reflects on what excites and worries him about dentistry’s future, and what leaders need to be successful in the coming years.

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Key Discussion Points and Insights

1. Major Issues in the Dental Industry

Timestamp: 01:03

• Medicaid Cuts

  • The recent passage of HR1 prompts states to plan responses to sweeping federal Medicaid cuts scheduled for 2026.
  • Cuts could result in about 10 million people losing insurance over the next decade.
  • Oral health benefits are frequently among the first eliminated during Medicaid budget reductions.
  • Steele emphasizes the urgent need to protect dental benefits for vulnerable populations.

  “Usually in these conversations from a policy perspective at the state level, on the chopping block first, when it comes to Medicaid is often oral health. So it’s become front and center for us and we’re in a little bit of protection mode...” (Matt Steele, 01:32)

• Fluoride in Public Policy

  • Fluoride is a politically charged issue with increased scrutiny, especially following high-profile debates involving public figures.
  • During the 2025 legislative session, 27 states introduced legislation on fluoridation—22 tried to restrict it, 7 aimed to protect it.
  • CareQuest sees maintaining community water fluoridation as critical.

  “Fluoride was a conversation with RFK Jr. in the race and has kind of been an exponentially increasing issue of attention within media and local policy decisions.” (Matt Steele, 01:39)

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2. Protecting Oral Health Benefits Amid Medicaid Cuts

Timestamp: 03:18

• CareQuest’s Protection Mode
  • Forming coalitions with local stakeholder groups, especially in states most at risk for severe Medicaid cuts.
  • Advocating for strategic, data-driven protection of dental benefits.
  • Sharing data from states that have cut benefits to illustrate negative consequences:
    • Illinois (2012): Cutting adult dental benefits led to a 128% increase in hospital admissions for dental issues.
    • California (2009): Medicaid rollback caused a loss of 4,500 jobs and $500 million in economic activity.

  “We’re trying to prevent that specifically from happening again within those states, but also more broadly...” (Matt Steele, 04:29)

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3. The Fluoride Debate: Roots and Risks

Timestamp: 04:59

• Origins of Skepticism and Policy Review
  • Sparked by national leaders raising concerns about water safety and public health.
  • Steele welcomes discussion, but stresses the importance of science-based evidence supporting fluoridation at safe levels.
  • Example from Calgary, Canada:
    • After fluoride removal, antibiotic use for children’s dental infections spiked by 700%.
    • Calgary eventually reinstated fluoridation due to significant health consequences.

  “We just want the conversation to be rooted in the data that shows the benefit of safe levels of community water fluoridation...” (Matt Steele, 05:11)

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4. Reasons for Optimism and Concern in Dentistry

Timestamp: 06:30

• Excitement

  • Encouraging policy wins at the state level:
    • Connecticut passed a bill protecting water fluoridation, spearheaded by local oral health coalitions.
  • Growing partnerships between local coalitions and policymakers to safeguard evidence-based dental care.

• Concerns

  • Significant uncertainty regarding the impact of HR1 and what Medicaid changes may mean for state budgets.
  • Many policymakers are still gauging implications for 2026-2027 and beyond.

  “We’re really watching that closely, watching how they’re engaging publicly about the topic and seeking to really insert ourselves into those conversations early...” (Matt Steele, 07:36)

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5. What Leaders Need for Future Success

Timestamp: 08:29

• Embrace Prevention

  • Preventative dental care is more effective and less costly than emergency interventions.
  • Lack of benefits leads to more emergency room visits for oral health crises.

  “I personally believe it’s always cheaper, smarter and healthier to prevent problems than to treat them later in an emergency room.” (Matt Steele, 08:35)

• Protect the Safety Net

  • Medicaid and community health centers are irreplaceable for oral health access.
  • Undermining these channels transfers costs elsewhere in the system.

• Defend Public Health Measures

  • Leaders must stand strong against politically motivated attacks on public health basics like fluoridation.
  • Emphasis on upholding policies rooted in robust scientific evidence.

  “Data and science need to kind of win the day here. And then thankfully there’s decades of it that support these basic and fundamental public health protections...” (Matt Steele, 09:50)

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Notable Quotes & Memorable Moments

• “Oral health benefits are often first on the chopping block when it comes to Medicaid.” (Matt Steele, 01:32)
• “Cutting adult dental benefits in 2012 led to a 128% spike in hospital admissions for dental issues [in Illinois].” (Matt Steele, 04:01)
• “In Calgary, Canada, where they removed community water fluoridation, antibiotic use for kids dental infections rose 700%...” (Matt Steele, 05:28)
• “Hoping that they’ll protect the safety net. Medicaid and community health centers are true lifelines, especially in oral health...” (Matt Steele, 09:25)

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Key Timestamps for Important Segments

• 00:21 — Guest Introduction
• 01:03 — Major Issues in Dental: Medicaid Cuts and Fluoride
• 03:18 — How CareQuest is Responding to Medicaid Threats
• 04:59 — The Fluoride Debate and Public Health
• 06:30 — What’s Exciting and Concerning in Dentistry Right Now
• 08:29 — What Future Leaders Need: Prevention, Protection, Advocacy

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Conclusion

Matt Steele’s conversation offers a clear-eyed look at the threats and opportunities facing oral health policy, emphasizing both the need for data-driven advocacy and proactive coalition-building. With Medicaid and community water fluoridation at the heart of current debates, organizations like CareQuest aim to ensure vulnerable populations are not left behind and that science continues to guide public health policy.

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Transcript

[A]

Hello, this is Ariana Portolatten with the Beckers Dental and DSO Review Podcast. I'm thrilled to be joined today by Matt Steele, the director of state and local advocacy for the Care Quest Institute for Oral Health. Matt, thank you so much for being here today. It's great to have you.

[B]

Thank you so much for having me. Honored to be here.

[A]

Great to start us off. Can you introduce yourself for our listeners and tell us a little bit about your background?

[B]

Absolutely. I am Matt Steele, the director of state and local advocacy at CareQuest Institute for Oral Health. Prior to this, I had worked for the association of Dental Support Organizations, also doing advocacy work. So I've been in the oral healthcare space for about the last little over four years and have really grown to love it and see how it's connected to total body Health. And as we'll talk about here in a little bit, it's kind of become front and center in a lot of the policy conversations across the country today.

[A]

Great. Thank you so much for that intro. First question here. What are some of the biggest issues that you're following in the dental industry right now?

[B]

Yeah, there's two major ones. The first, and probably to no one's surprise, is Medicaid. With the passage of HR1 or the one big beautiful bill in Congress recently, several state houses have been responding or beginning to plan how they're going to respond in 2026 to the sweeping Medicaid cuts. For those who just want a quick a briefer on how severe some of these cuts are, the Congressional Budget Office is projecting that these changes could leave about 10 million people uninsured over the next decade. So the cuts are going deep. And usually in these conversations from a policy perspective at the state level, on the chopping block first, when it comes to Medicaid is often oral health. So it's become front and center for us and we're in a little bit of protection mode to make sure that these benefits are still available for the most vulnerable parts of our society. In addition to that, we're also focusing heavily on fluoride. To no surprise, even prior to President Trump getting elected to office, fluoride was a conversation with RFK Jr. In the race and has kind of been a exponentially increasing issue of attention within media and local policy decisions for a few years actually now. But this in this last legislative session cycle in 2025, it became front and center. We had 27 states introduce legislation around fluoride. This year, 22 states were trying to restrict fluoride, seven were trying to protect it in their water systems in some way, shape or form. So clearly state houses are really honing in on this and it's something that we're planning to engage on. Seeing that fluoride is often a first line of defense for oral health care.

[A]

A lot to cover there. Thank you so much for starting us off. Wanted to dig a little bit deeper into the Medicaid issue as well. I know. I've spoken with other dental leaders about how dental benefits are, like you said, kind of first on the chopping block when it comes to these cuts. Mentioned that you're in protection mode. What does protection mode look like for your organization as of right now?

[B]

Right now it's looking like connecting with different oral health care stakeholder groups and networks at states that we feel like the cuts are going to be most severe. We're having conversations with them to develop advocacy plans and strategies to best protect the possibility of cuts in those states when it comes to the next session cycle. And so we're. We're hoping that these conversations can develop a plan that will result in the essential nature of this care being maintained for not just the next cycle, but years to come. There's been a lot of data that's come out recently showcasing in some states where cuts have happened before how detrimental they were to those who needed the oral health care the most. For instance, in Illinois, cutting adult dental benefits in 2012 led to 128% spike in hospital admissions for dental issues. And in California, there was a rollback in 2009 that cost about 4,500 jobs and about 500 million in lost economic activity. So we're trying to prevent that specifically from happening again within those states, but also more broadly as they consider their budgets moving forward.

[A]

Okay. And to touch on fluoride a little bit more as well. I know you mentioned definitely the conversation on Florida has been happening for quite some time now, even before was elected to office. What do you think sparked those discussions, I guess, and the skepticism around fluoride?

[B]

I think part of what sparked the discussions was just higher and higher profile policy leaders within our country beginning to raise their own awareness about community water and the role that it plays in health in general. And we're hoping that, that we can keep the conversation going. It's not that we don't mind the conversation, but we just want the conversation to be rooted in the data that shows the benefit of safe levels of community water fluoridation, but also kind of peels back the curtain on some of the drawbacks to taking those safe levels out of our public water systems. One example I'll just mention real quick in Calgary, Canada where they removed community water fluoridation, they the antibiotic use for kids dental infections rose 700% after fluoride was removed. They reinstated safe levels of community water fluoridation actually after removing it because the health consequences were so severe. So we're hoping to avoid that as awareness continues to be raised on these issues from public health leaders at a national level and at a local level.

[A]

Right, yeah, that makes a lot of sense. Thank you for sharing more about that also. And next question here. You might have some similar responses here as well. But what are you most excited about when it comes to dentistry right now and what makes you nervous about the industry?

[B]

Yeah, I'm excited on one end from some of the proactive policy responses I'm seeing in these two areas. Some of those responses at the state level have been very encouraging. One example I'll just mention off the top of my head is in Connecticut. The there was of all the bills introduced this past legislative session cycle, as I mentioned earlier, there was a few states that introduced legislation to protect community water fluoridation. Connecticut was one of them. And it was the oral health Care network within that state that helped spearhead a bill to protect safe levels of community water fluoridation within the state and really insulating that from any federal or national activity. So I'm excited to see local oral health care coalitions partnering with their policymakers to protect these data driven and science backed approaches to oral health care. We're carefully watching a lot of obviously what happens on Medicaid. I think with the recent passage of H R1, the there's a lot of policymakers who still are reading through all the implications, understanding what that means for their own states and are kind of in the early gestation phases of what it will mean for their budgets coming into 2026 and 2027 with states that are doing budgets on a biennial cycle. And so we're really watching that closely, watching how they're engaging publicly about the topic and seeking to really insert ourselves into those conversations early so we can make sure that oral health care and preserving it for our most vulnerable populations is at the front of their mind.

[A]

Okay, great. And last question for you here. What will the most effective healthcare leaders need to be successful in the next two to three years?

[B]

Yeah, that's a great question. I think they'll need to do a couple things. One is they'll need to embrace prevention. I personally believe it's always cheaper smarter and healthier to prevent problems than to treat them later in an emergency room. And emergency rooms often are where oral health care goes once some of these benefits are cut or drawn back. And it's always more surgical in those spaces, they're in an emergency room, they're trying to just filter through as many people who are having emergency issues as possible. So taking care of them and taking care of oral healthcare issues in a more nuanced and patient centered fashion is an always the case in these contexts. So hoping that through focusing on prevention, oral healthcare leaders can stop the consequences of really seeing a lot of this care siphoned off to emergency rooms when the access to care is stifled. In addition to that, hoping that they'll protect the safety net. Medicaid and community health centers are true lifelines, especially in oral health, and undermining them only shifts the cost costs elsewhere in the system. And the last thing I'll just mention beyond that is leaders will need to be willing to take a stand against any politically motivated attacks on public health measures like fluoride. Data and science need to kind of win the day here. And then thankfully there's decades of it that support these kind of basic and fundamental public health protections that we hope to see remain in place for the next several years.

[A]

Great. Thank you so much for the engaging and interesting conversation today. That is all I have for you today, Matt. So thank you again so much for joining our podcast. Been a pleasure speaking with you and looking forward to connecting with you again in the future.

[B]

Thank you so much for having me on today and looking forward to it as.