Effect of Medicaid dental coverage and Medicaid expansion on dental care utilization among low-income adults

Abstract

Income-based disparities in dental health have long been an issue in the United States. Despite the importance of maintaining good oral health, many low-income adults remain uninsured for dental care. Medicaid serves as the primary source for many low-income adults who cannot obtain private dental insurance. Since states have discretion on the level of dental benefits provided to Medicaid enrollees, it is no surprise that benefits vary widely from state to state. Adult Medicaid dental benefits have four different tiers, ranging from comprehensive to no coverage. I apply a difference-in-difference approach and a synthetic control approach to examine Medicaid’s multivalued treatment effects on dental utilization by low-income adults over the period 2002 through 2016. Using Medical Expenditure Panel Survey data (MEPS) and other supplementary datasets, my results show that an increase in the comprehensiveness of the state Medicaid dental benefits leads to an increase in the probability that a low-income non-elderly adult visited a dentist in the previous year. The more generous the coverage, the stronger the effect. The result sheds light on how we can alleviate the gap between low-income and other income groups regarding dental care access.