For the second year in a row, Kentucky’s state House has passed a bill that would make water fluoridation optional for local utility providers.
A bill to remove Kentucky’s state water fluoridation mandate has been introduced in nearly every General Assembly session since 2018, but advanced out of the state House for the first time last year.
Representatives voted 67-29 on Thursday to approve the measure that, if enacted into law, would get rid of the state’s mandate for water systems to add fluoride to their supplies in order to – as the statute reads – “protect the dental health of the people served by the supply.”
Water fluoridation has long been recognized as one of the best public health campaigns of the 20th century, and is widely credited with helping to lower tooth decay rates.
However, some studies, including a 2024 meta-analysis by the federally-run National Toxicology Program have suggested some fluoride levels – ones that are much higher than what’s currently recommended in the U.S. – could negatively impact children’s IQ scores. The Environmental Protection Agency, following directives from Health and Human Services Secretary Robert F. Kennedy Jr., is advancing a fast-track review of potential health risks fluoride could cause.
Florida and Utah both banned the use of fluoride in public water supplies last year. Kentucky Republican state Rep. Mark Hart, the lead sponsor of the optional fluoridation measure, said the bill does not go that far. Instead, he said it just removes Kentucky’s fluoridation requirement and puts the choice in the hands of local stakeholders.
“We're trying to just undo an unfunded mandate. Let the people closest to the water, let the people drinking the water, make the decisions,” Hart said.
Democratic Rep. Rachel Roarx, however, argued the decision of whether to fluoridate water supplies should stay with experts.
“Our state health department is the appropriate entity to make this determination that has to do with public health. Our local water boards possess no requirement to have medical or health expertise, but our state health departments do,” she said on the House floor Thursday.
A coalition that includes Kentucky health advocacy groups, healthcare providers and the Louisville Water Company sent a letter to lawmakers against HB 103, arguing that the statewide fluoridation requirement helps reduce the incidence of cavities, especially for people without access to regular dental care.
Data from a 2023 University of Kentucky College of Dentistry survey suggest that cavity rates and untreated tooth decay rates for children between the ages of 2 and 5 in the commonwealth are “significantly higher” than the national average.
Democratic Rep. Anne Gay Donworth said, if the measure is enacted into law, it could drive up the state’s costs for caring for a potential increase in dental issues for Medicaid enrollees without access to fluoridated water. Dental health advocacy groups suggest that, for every 10% of the state’s population that loses access to fluoridated water, Medicaid costs will increase by nearly $20 million annually.
But Republican Rep. Matt Lockett said HB 103 is ultimately about giving local communities a say in their fluoride practices.
“I would encourage those that would be opposed to this bill, if you say that we have to have fluoride in our water, go and make your pitch to the individual local governments as they're deciding whether or not to put it in their local water supply,” Lockett said.
HB 103 will now go to the state Senate for consideration. A separate optional water fluoridation measure has also been introduced in the Senate, but has not yet received a committee assignment.
