The Public and Private Dental Safety Net: Implementation of the ACA and their Roles in Access to Care for Medicaid and Expansion Populations

The capacity of the public (community health centers) and private (private practitioners) dental safety net will be stretched through the expansion of dental coverage to an estimated 20.9 million primarily adults through the ACA’s Medicaid expansion. Current and future capacity of the dental safety net was evaluated through a study of CHCs and private practice dentists in Iowa, as a way to model issues for other parts of the country. Access was found to be limited in the private dental safety net: only 16% of private practitioners accepted all new Medicaid patients, while the other 84% accepted either only some new (42%) or no new (42%) Medicaid patients. The public dental safety net was also limited in that there are only 14 clinics in the state and although they expected demand to increase, they reported limitations in their ability to respond. New programs may need to be developed so that access to dental care can meet the expected demand.