Participants should be aware of the following financial/non-financial relationships: . Aparna Ingleshwar, BDS, MPH: I do not have any relevant financial / non-financial relationships with any proprietary interests.. Peter Damiano, DDS, MPH: I do not have any relevant financial / non-financial relationships with any proprietary interests.. Dan Shane, PhD: I do not have any relevant financial / non-financial relationships with any proprietary interests.. Elizabeth T. Momany, MA, PhD: I do not have any relevant financial / non-financial relationships with any proprietary interests.. Natoshia M. Askelson, MPH, PhD: I do not have any relevant financial / non-financial relationships with any proprietary interests.. Michael Jones, MA, PhD: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Abstract: Objective To examine the impact of states’ Medicaid expansions on out-of-pocket dental care spending for states that provided extensive adult dental benefits as compared to non-expansion states that mostly provided limited or emergency-only benefits.
Methods Restricted data for years 2011-2017 were obtained from the Medical Expenditure Panel Survey. Sample included income-eligible (138% Federal Poverty Level) adults aged 21-64 years with at least one annual dental visit. Outcome was annual out-of-pocket dental care spending ($). Difference-in-difference (DID) study design with two-part modeling approach was utilized to analyze post-expansion year-by-year changes (for 2014, 2015, 2016, 2017) in: a) probability of incurring any out-of-pocket dental spending, and b) amount of out-of-pocket spending, between expansion states with extensive benefits and non-expansion states, relative to pre-expansion period (2011-2013).
Results On average, a greater proportion of adults in expansion states with extensive dental benefits (58%;2011-2017) reported zero dollars in out-of-pocket dental care spending, compared to those in non-expansion states (31%;2011-2017). Our DID analysis found that, compared to non-expansion states, adults residing in states that provided extensive adult dental benefits and expanded Medicaid were significantly less likely to incur any out-of-pocket spending in the first two years of implementing the expansion (2014 and 2015). Conclusion Comprehensive dental benefits in Medicaid adult dental programs appears to be protective against incurring any out-of-pocket expense for utilizing dental care. Thus, states that expand Medicaid eligibility and provide comprehensive coverage can effectively reduce cost barriers to dental care for low-income adults who don’t have the means to pay out of pocket.
Source of Funding: Funding for this project included: (i) a seed grant from the Central Plains Research Data Center at the University of Nebraska, and research Grant from the University of Iowa Graduate and Professional Student Senate”.
Affiliations: Affiliations: 1. College of Dentistry, University of Iowa 2. Public Policy Center, University of Iowa 3. College of Public Health, University of Iowa
