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This study evaluated the economic impact of a policy change in adult Maryland Medicaid dental benefits that eliminated reimbursements to dentists. We examined all claims for 2 years before and after the change. Reimbursements to dentists fell to zero from their preenactment period annual rate of $7.6 million; other care settings simultaneously generated an additional $232,470 savings during the postenactment period. Medicaid's goal to reduce costs was achieved; however, disadvantaged patients may have been confused by the policy change and likely suffered poorer health outcomes and paid for treatment out of pocket, found free clinics, or received free care from generous dentists.