{ legislative & regulatory } 2026 Legislative Session Recap by GRACE RILEY T


he 2026 Regular Session of the 103rd Missouri General Assem- bly officially adjourned at 6 p.m. on Friday, May 15, 2026, closing


what was, by many measures, one of the more productive sessions in recent memory. The session marked a notable contrast to last year’s regular and special sessions, when the Senate used the “previous question” motion four separate times. The previous question, often referred to as the PQ, is a procedural move that cuts off debate and forces an immediate vote. The Missouri Senate uses it sparingly because it breaks the chamber’s long-standing tradition of unlimited debate.


This year still included controversy and stalemate, but many disagreements appeared to be driven more by policy differences than personality conflicts, and the overall deco- rum of the building held through the final gavel. In total, 100 policy and spending bills crossed the finish line before the constitu- tional deadline and were Truly Agreed To and Finally Passed (TAFP).


MDA Legislation DENTAL LOSS RATIO


Although Dental Loss Ratio legislation did not advance to hearings during the 2026 legislative session, the More for Your Smile campaign generated meaningful momentum by continuing to educate legislators on how dental insurance functions and where gaps in transparency and accountability exist.


The campaign mobilized almost 300 in- dividuals, who sent more than 500 emails to their legislators. Those contacts helped reinforce that dental insurance reform is not only a provider issue, but also a patient issue tied to the value Missourians receive from their premium dollars.


16 focus | SUMMER 2026 | ISSUE 2


Throughout discussions with policy makers, some concerns were raised about whether Dental Loss Ratio standards could increase premiums or reduce insurer participation in the market. As additional data and examples from other states continue to show that these policies do not lead to higher premi- ums or widespread insurer exits, MDA sees continued opportunity for future legislative movement.


The More for Your Smile initiative has further positioned MDA and Missouri dentists as trusted advocates not only for oral health, but also for patients navigating increas- ingly complex dental benefit structures and insurance systems. Looking ahead, MDA anticipates continuing these conversations and considering future legislation focused on transparency and reporting requirements regarding how premium dollars are spent within dental insurance plans. MDA plans to renew these efforts during the 2027 legisla- tive session.


Monitored Legislation


DENTIST & DENTAL HYGIENIST LICENSURE COMPACT


The Dentist and Dental Hygienist Compact legislation ultimately did not advance to final passage. Unlike many other issues during the 2026 legislative session, debate surrounding the compact at times appeared to be shaped as much by stakeholder dynamics as by broader policy disagreements.


Even so, senators raised substantive concerns regarding the constitutionality of interstate compacts, potential implementation costs, the delegation of authority away from the Legislature, and whether bad actors could more easily move between states and con- tinue practicing.


With several senators facing term limits, it remains to be seen where controversy sur- rounding compact legislation may continue. If the measure is re-filed by the Association of Dental Support Organizations, ongoing discussions will be important to strengthen relationships with senators who will remain in office. MDA was also encouraged that the competing proposal tied specifically to the ADEX examination did not advance.


WATER FLUORIDATION


Senate Bill 1548, which would have pro- hibited public water systems from adding fluoride to drinking water, was not heard during the 2026 legislative session. Because the bill sponsor is serving her final year, MDA will continue monitoring whether similar legislation is re-filed in future sessions and will remain prepared to respond strategically with evidence-based education and stake- holder coordination if necessary.


AMERICANS WITH DISABILITIES ACT WEBSITE LITIGATION


Legislation addressing Americans with Disabilities Act website litigation passed and was signed into law during the 2026 session. The measure provides Missouri dentists with an important defense tool when facing lawsuits alleging their websites are not ADA compliant, though it would not automatical- ly dismiss claims or excuse noncompliance. Read more about this topic on page 18.


Appropriations


The Fiscal Year 2027 budget maintained the increased reimbursement rates for Missouri dental Medicaid providers originally imple- mented in 2022. The budget also maintained funding for the general anesthesia dental codes approved last year at approximately 63 percent of the 50th percentile usual, custom- ary and reasonable (UCR) rate. Funding for


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32