The Impact of the ACA Medicaid Expansions on Dental Visits by Dental Coverage Generosity and Dentist Supply

George L Wehby; Wei Lyu; Dan M Shane

doi:10.1097/MLR.0000000000001181

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The Impact of the ACA Medicaid Expansions on Dental Visits by Dental Coverage Generosity and Dentist Supply

Journal article

Peer reviewed

The Impact of the ACA Medicaid Expansions on Dental Visits by Dental Coverage Generosity and Dentist Supply

George L Wehby, Wei Lyu and Dan M Shane

Medical care, Vol.57(10), pp.781-787

10/2019

DOI: 10.1097/MLR.0000000000001181

PMCID: PMC6742569

PMID: 31433313

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https://www.ncbi.nlm.nih.gov/pmc/articles/6742569View

Open Access

Abstract

Low-income adults in the United States have historically had limited access to dental coverage and poor dental health outcomes. We examined the effects of the Affordable Care Act Medicaid expansions on dental visits among low-income adults focusing on the generosity of dental coverage and heterogeneity in effects by dentist supply. We used data from 2012, 2014, and 2016 Behavioral Risk Factor Surveillance System surveys. The main analytical sample included nearly 117,000 individuals <138% federal poverty level. We employed a quasi-experimental difference-in-differences design to identify the impact of the state Medicaid expansions on having a dental visit in the past 12 months by the generosity of dental coverage and dentist supply. Medicaid expansions were associated with a nearly 6 percentage-point increase in the likelihood of any dental visits in 2016 (over 10% increase from preexpansion rate) for individuals in Medicaid expanding states with extensive dental benefits. This increase, however, was concentrated in states with high dentist supply with no evidence of improvement in utilization in states with limited dental coverage or low dentist supply. Expanding Medicaid with generous dental coverage improved dental care use only in areas with high dentist supply with no evidence of benefits with low dentist supply or less generous coverage. Improving access to dental care may require both generous coverage and supply-side interventions to increase dentist availability.

Adult

Behavioral Risk Factor Surveillance System

Dental Care - statistics & numerical data

Dentists - supply & distribution

Female

Health Services Accessibility

Humans

Insurance Coverage - statistics & numerical data

Insurance, Dental - statistics & numerical data

Male

Medicaid - legislation & jurisprudence

Medicaid - statistics & numerical data

Patient Protection and Affordable Care Act

Poverty - statistics & numerical data

United States

Dental Medicaid

Details

Title: Subtitle: The Impact of the ACA Medicaid Expansions on Dental Visits by Dental Coverage Generosity and Dentist Supply
Creators: George L Wehby - National Bureau of Economic Research, Cambridge, MA
Wei Lyu - Departments of Health Management and Policy
Dan M Shane - Public Policy Center, University of Iowa, Iowa City, IA
Resource Type: Journal article
Publication Details: Medical care, Vol.57(10), pp.781-787
DOI: 10.1097/MLR.0000000000001181
PMID: 31433313
PMCID: PMC6742569
NLM abbreviation: Med Care
ISSN: 0025-7079
eISSN: 1537-1948
Grant note: R03 DE028041 / NIDCR NIH HHS
Language: English
Date published: 10/2019
Academic Unit: Preventive and Community Dentistry; Health Management and Policy; Economics; Public Policy Center (Archive); Oral Health Policy Research
Record Identifier: 9984214704502771

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