Association between Medicaid expansion, dental coverage policies for adults, and children's receipt of preventive dental services.
OBJECTIVE
To examine whether low-income children's use of preventive dental services is linked to variation in state Medicaid policies that affect parents' access to dental care in Medicaid.


DATA SOURCES
Medical Expenditure Panel Survey (2011-2016), Area Health Resources File, and Medicaid adult dental coverage policies.


STUDY DESIGN
We conducted a quasi-experimental analysis using linked parent-child dyads in low-income families (≤125 percent of the Federal Poverty Level). We assessed whether expansions of Medicaid to low-income adults under the Affordable Care Act were associated with increases in the use of preventive dental services among low-income children when state Medicaid programs did vs did not cover these services for adults.


PRINCIPAL FINDINGS
Over the study period, 37.8 percent of low-income children received at least one annual preventive dental visit. We found no change in children's receipt of preventive dental care associated with Medicaid expansions in states that covered (1.26 percentage points; 95% CI: -3.74 to 6.27) vs did not cover preventive dental services for adults (3.03 percentage points; 95% CI: -2.76 to 8.81). (differential change: -1.76 percentage points; 95% CI: -8.09, 4.56). However, our estimates are imprecise, with wide confidential intervals that are unable to rule out sizable effects in either direction.


CONCLUSION
We did not find an association between Medicaid expansions with concurrent coverage of preventive dental services for adults and children's use of these services. Factors other than parental access to dental benefits through Medicaid may be more salient determinants of preventive dental care use among low-income children.
['Khouja|Tumader|T|0000-0001-6042-4866', 'Burgette|Jacqueline M|JM|0000-0001-5677-6295', 'Donohue|Julie M|JM|0000-0003-2418-6017', 'Roberts|Eric T|ET|0000-0002-7439-0799']
D000293:Adolescent D000328:Adult D002648:Child D003729:Dental Care D005260:Female D006801:Humans D019458:Insurance Coverage D007347:Insurance, Dental D008297:Male D008484:Medicaid D010290:Parents D010342:Patient Acceptance of Health Care D058991:Patient Protection and Affordable Care Act D011203:Poverty D012959:Socioeconomic Factors D014481:United States
Medicaid dentistry state health policies