AB 3129: A misguided bill that risks California’s oral health

OPINION – This week, the California Senate will vote on AB 3129, which would eliminate private equity funding for many healthcare providers — including dental practices — and require providers with over $25 million in revenue to receive the Attorney General’s approval before entering into mergers or acquisitions. As a dentist committed to improving access to high-quality oral healthcare, I am alarmed by the potential impact on patients across our state. The bill would severely restrict access to dental care for millions of Californians, eliminating many dental homes and curbing the industry’s ability to innovate and invest in state-of-the-art technology.

AB 3129 was intended to address costs associated with hospital mergers and acquisitions. As data has shown, consolidations have led to increased costs for patients. Yet, after a series of amendments, hospitals — the biggest cost drivers — have been carved out of AB 3129. Simply put, the bill arbitrarily picks winners and losers, exempting the wealthy hospitals it was meant to take on while adding burdensome regulations and scrutiny for emergency care, reproductive health, mental health, and dental care providers at the expense of patients.

If passed by the Legislature and signed by Governor Newsom, AB 3129’s regulatory hurdles would hinder dental practices’ ability to operate and open new offices. This further marginalizes the more than 15 million low-income Californians relying on Denti-Cal, as most beneficiaries receive care from privately funded practices. In fact, according to an August 2024 dentistry study published in HealthAffairs, “private equity-affiliated practices were more likely to participate in Medicaid than practices not affiliated with private equity.” As a result, private equity-affiliated dental practices effectively lower healthcare costs.  AB 3129’s restrictions would reduce access to critical dental services for Denti-Cal patients, who may face longer drives and wait times for appointments. As a result, many of the most economically vulnerable Californians would have to miss a day’s work or forego necessary dental care treatments — additional expenses they cannot afford. Additionally, this would discourage providers from expanding into rural communities that already lack the adequate number of providers necessary to address their population’s needs.

This legislation comes as the dental industry is already facing a provider shortage. A significant percentage of practicing dentists are nearing retirement age, while new graduates — about 40 percent of whom primarily rely on privately funded practices for employment — are struggling to find opportunities. It is no surprise that the University of California has come out against the bill. By adding more regulations, AB 3129 limits opportunities for the next generation of dentists, exacerbating the existing dental workforce crisis, and straining access for Californians.

The financial implications of AB 3129 would also add millions in annual costs that California taxpayers would have to foot. The bill introduces an appeal process that would allow providers to challenge the Attorney General’s decision. However, this process is expected to add millions in costs to California’s General Fund. Additionally, in its opposition letter, the University of California estimates that legal costs associated with the review process would cost up to $1 million for each transaction, depending on size and complexity.

California has already invested millions in the Office of Health Care Affordability (OHCA) to collect comprehensive data on the state’s healthcare system, analyze cost drivers, and develop data-driven policies to improve affordability. This includes oversight of healthcare mergers and acquisitions. In other words, OHCA already addresses the issues AB 3129 aims to tackle. The key difference between OHCA’s task and AB 3129 is that the latter prematurely assumes the nature of the problem and proposes a one-size-fits-all solution rather than a data-driven policy. By bypassing OHCA’s data-driven approach, the bill risks implementing measures that would be ineffective and harmful to patients, providers, and taxpayers.

AB 3129 is deeply flawed legislation that would undermine California’s healthcare system — and the health of Californians — by imposing unnecessary and costly regulations. It is a cluster of harmful policies targeting dental practices and other healthcare providers while exempting the very entities it was initially designed to regulate. In doing so, the bill risks creating a landscape where patients are left with fewer options, longer wait times, and diminished quality of care. Its financial burden on taxpayers, coupled with its potential to worsen workforce shortages and limit access to dental care, makes it clear that AB 3129 is not the solution California needs. Instead of moving forward with this misguided approach, Dr. Wood and the legislature should focus on data-driven policies that truly address care affordability and access without sacrificing the well-being of millions of Californians.

Dr. Timothy Herman is the owner and president of Herman Dental Corporation, dba A+ Dental Care, with offices in Roseville and Lincoln, California.