Fewer than half of all U.S. states provide dental care for non-elderly adult Medicaid enrollees. Although the Affordable Care Act (ACA) expands Medicaid eligibility for adults, states are not required to offer dental care to adults. We project the effect of the ACA on patient-identified barriers to dental care based on a framework developed using data from a 2008 survey of Minnesota Medicaid enrollees with and without an annual dental visit. The rate of annual visits (55%) was below that of all Minnesotans (79%) with 40% reporting difficulties accessing services. We found no racial/ethnic disparities in annual dental visits among adult Medicaid enrollees. Adult Medicaid recipients with no annual visit reported individual (51%), provider (27%), and system-level (22%) barriers. Hmong, Somali, and American Indian adults were more likely than others to report barriers to receiving dental care. We project that the ACA will not reduce barriers to dental care for adult Medicaid enrollees.