title: Medicaid Adult Dental Benefits Increase Use Of Dental Care, But Impact Of Expansion On Dental Services Use Was Mixed.
abstract: Dental coverage for adult enrollees is an optional benefit under Medicaid. Thirty-one states and the District of Columbia have expanded eligibility for Medicaid under the Affordable Care Act. Millions of low-income adults have gained health care coverage and, in states offering dental benefits, oral health coverage as well. Using data for 2010 and 2014 from the Behavioral Risk Factor Surveillance System, we examined the impact of Medicaid adult dental coverage and eligibility expansions on low-income adults' use of dental care. We found that low-income adults in states that provided dental benefits beyond emergency-only coverage were more likely to have had a dental visit in the past year, compared to low-income adults in states without such benefits. Among states that provided dental benefits and expanded their Medicaid program, regression-based estimates suggest that childless adults had a significant increase (1.8 percentage points) in the likelihood of having had a dental visit, while parents had a significant decline (8.1 percentage points). One possible explanation for the disparity is that after expansion, newly enrolled childless adults might have exhausted the limited dental provider capacity that was available to parents before expansion. Additional policy-level efforts may be needed to expand the dental care delivery system's capacity.
authors.affiliation: Astha Singhal (asinghal@bu.edu) is an assistant professor of health policy and health services research at the Henry M. Goldman School of Dental Medicine at Boston University, in Massachusetts.
authors.forename: Astha
authors.initials: A
authors.lastname: Singhal
authors.affiliation: Peter Damiano is a professor of preventive and community dentistry and director of the Public Policy Center at the University of Iowa, in Iowa.
authors.forename: Peter
authors.initials: P
authors.lastname: Damiano
authors.affiliation: Lindsay Sabik is an associate professor of health policy and management at the University of Pittsburgh, in Pennsylvania.
authors.forename: Lindsay
authors.initials: L
authors.lastname: Sabik
mesh_terms: D000328:Adult; D040343:Behavioral Risk Factor Surveillance System; D003729:Dental Care / Q000706:statistics & numerical data*; D004219:District of Columbia; D004608:Eligibility Determination / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007347:Insurance, Dental / Q000706:statistics & numerical data*; D008297:Male; D008484:Medicaid / Q000191:economics / Q000706:statistics & numerical data*; D008875:Middle Aged; D011203:Poverty; D014481:United States
keywords: Access To Care; Affordable Care Act; Dental; Managed Care - Medicaid < Managed Care