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

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.

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)

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)

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)

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)

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)

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)

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

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.