Expanded Medicaid dental coverage under the Affordable Care Act: an analysis of Minnesota emergency department visits.
OBJECTIVE
Hospital emergency departments (EDs) function as the safety net for patients with non-traumatic dental conditions (NTDCs). With the implementation of Medicaid expansion under the Affordable Care Act (ACA) many adults became eligible for dental benefits. We examined the impact of "early" Medicaid expansion in Minnesota on ED visits for NTDCs from 2008 (prereform) to 2014 (postreform).


METHODS
Data from the State Emergency Department Databases for Minnesota were analyzed for 2 years: 2008 and 2014. All individuals who presented to the ED with a dental problem were identified based on the International Classification of Diseases, Ninth Revision, Clinical Modification with a primary diagnosis of 520.0-529.9. Demographic variables including patient age, gender, and primary payer were examined.


RESULTS
Between 2008 and 2014 there was a 18.8 percent increase in the number of all non-dental ED visits and a 9.7 percent decrease in the number of NTDC visits. In that time period, young adults 18-26 years old showed a significant decrease (19.3 percent, P < 0.001) in the number of NTDC visits.


CONCLUSIONS
The Minnesota experience suggests that the increase in Medicaid dental benefits through the ACA has significantly decreased NTDC visits, especially among young adults who were eligible for a dependent coverage policy that extends parents' health insurance to age 26. To our knowledge, no previous study has reported on the impact of early Medicaid expansion on the rate of ED use for NTDCs.
Department of Dentistry, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Nadia
N
Laniado
Department of Dentistry, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Victor M
VM
Badner
Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA.
Ellen Johnson
EJ
Silver
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003729:Dental Care / Q000191:economics*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008484:Medicaid / Q000191:economics* / Q000331:legislation & jurisprudence*; D008875:Middle Aged; D008910:Minnesota; D058991:Patient Protection and Affordable Care Act; D014481:United States
Affordable Care Act; Medicaid; Minnesota; dental care utilization; emergency department