Six months into the pandemic and resulting national economic crisis, state policymakers are making – and will continue to have to make – tough budget decisions. As advocates, it is our job to make the case that essential health and economic programs, like oral health coverage, are a responsible investment of scarce resources. As we prepare to do this work in the coming months, it is time to take a moment to reflect on the progress, threats, and trends we’ve seen in Medicaid adult dental coverage so far this year. There is a lot to learn from how policymakers are reacting to our uncertain environment, and there are clear lessons that will help us position ourselves for future success in oral health policy. This analysis provides a summary of state activity on Medicaid adult dental coverage this year, and shares lessons for advocacy planning as we approach 2021.