The Affordable Care Act (ACA) increased rates of dental coverage by 18.9 percentage points in states that provide dental benefits through Medicaid, according to researchers at the Harvard School of Dental Medicine (HSDM) who examined data from the National Health Interview Survey showing how ACA expansion of Medicaid eligibility affected dental coverage and the use of oral health services among low-income adults.
In terms of utilization, the researchers said expansion states that provide dental benefits saw the greatest increase in people having a dental visit in the past year (7.2 percentage points). However, there was no significant change in the overall share of people who had a dental visit in the past year, although the expansion was associated with a significant increase in this metric among white adults.
The expansion also was associated with finding an increase in complete tooth loss, suggesting that once low-income adults gained access to dental services, the condition of their oral health was in a deteriorated state and necessitated extraction. Ensuring routine access to preventive oral health services could then improve oral health and prevent tooth loss in the low-income population, the researchers said.
The findings additionally suggest that there are other persistent barriers to access to dental care, the researchers said, particularly among members of racial and ethnic minority groups. In fact, “coverage for and access to dental services have been challenges to vulnerable populations for many years,” said Jane Barrow, associate dean for Global and Community Health and executive director of HSDM’s Initiative to Integrate Oral Health and Medicine.
“Policy makers have struggled with measuring improvements to oral health through public programs, particularly among adult Medicaid beneficiaries,” said Barrow, adding that the study provides new insights into the impact of the ACA on dental coverage. “We are excited about the visibility this article will give to oral health policy issues, and look forward to further study.”
The study, “Changes in Coverage and Access to Dental Care Five Years After ACA Medicaid Expansion,” was published by Health Affairs.