Changes in pediatric dental coverage and visits following the implementation of the affordable care act

Abstract

Objective: To determine the impact of the inclusion of pediatric dental care in the Affordable Care Act's (ACA) core package of essential health benefits on dental coverage and utilization. Data Sources: Children aged 1-18 years included in the nationally representative 2010-2015 National Health Interview Survey (NHIS). Study Design: We used regression-adjusted difference-in-differences to examine changes in rates of dental coverage and visits pre- and post-ACA for children likely to be affected by the ACA (have a parent working for a small employer) to a comparison group of children who were unlikely to be affected (have a parent in a firm with ≥50 employees). Models adjusted for relevant health and sociodemographic measures. Data Collection: NHIS is an annual household survey conducted by the National Center for Health Statistics. Principal Findings: Comparing pre- and post-ACA periods, private dental insurance increased by 4.6 percentage points more (P = 0.013) and annual dental visits were unchanged (2.7 percentage points, P = 0.071) among children likely to be affected by the ACA compared to children unlikely to be affected by the ACA. Conclusion: Inclusion of pediatric dental care as an ACA essential health benefit increased dental insurance coverage, but not dental visits among children likely to be affected by this policy.