Estimating Premium and Out-of-Pocket Outlays Under All Child Dental Coverage Options in the Federally Facilitated Marketplace

Vujicic, Marko; Yarbrough, Cassandra

doi:10.1016/j.jpeds.2016.11.045

Cited by 6 publications

(9 citation statements)

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“…Although the ACA aims to make pediatric dental coverage more available, it does little to address other barriers to dental care. Many factors affect children's receipt of dental care beyond dental coverage, including cost, distance to care, and parents’ prioritization of oral health . For example, in 2014, the maximum out of pocket cost on stand‐alone pediatric dental plans was $700 for a single child, which decreased to $350 in 2015 .…”

Section: Discussionmentioning

confidence: 99%

“…Many factors affect children's receipt of dental care beyond dental coverage, including cost, distance to care, and parents’ prioritization of oral health . For example, in 2014, the maximum out of pocket cost on stand‐alone pediatric dental plans was $700 for a single child, which decreased to $350 in 2015 . It is possible that there may be a delayed effect and that it may take more time to see a relationship between the ACA and dental visits.…”

Section: Discussionmentioning

confidence: 99%

“…Requiring all health plans to embed pediatric dental coverage could also help to reduce patient costs. A study of expected out of pocket costs for pediatric dental care reported that costs were lower when dental coverage was embedded within a medical plan compared to stand‐alone dental plans …”

Section: Discussionmentioning

confidence: 99%

“…23 For example, in 2014, the maximum out of pocket cost on stand-alone pediatric dental plans was $700 for a single child, which decreased to $350 in 2015. 21 It is possible that there may be a delayed effect and that it may take more time to see a relationship between the ACA and dental visits. For example, studies of states expanding adult Medicaid dental benefits via the ACA reported no change in dental visits after one year, 24 and significant increases in dental visits after three years.…”

Section: Robustness Checksmentioning

confidence: 99%

“…A study of expected out of pocket costs for pediatric dental care reported that costs were lower when dental coverage was embedded within a medical plan compared to stand-alone dental plans. 21 Finally, eleven Senators wrote to HHS Secretary Burwell in 2016 requesting a standardized definition of the pediatric benefits included in the EHB package. 27 Because each state has its own benchmark health plan outlining the minimum scope of services to be covered, there is much variation in the pediatric services covered by states, including the types of dental services covered.…”

Section: Robustness Checksmentioning

confidence: 99%

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

Kranz

Dick

2018

Health Services Research

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Robustness Checksmentioning

confidence: 99%

Section: Robustness Checksmentioning

confidence: 99%

See 3 more Smart Citations

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

Kranz

Dick

2018

Health Services Research

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Time for Dental Care to Be Considered Essential in US Health Care Policy

Vujicic

Fosse

2022

AMA Journal of Ethics

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Training, service delivery, and financing are done separately in dentistry and general health care, which has influenced reimbursement structures, access to services, and outcomes. This article considers how medical and dental separation exacerbates health inequity and canvasses data demonstrating that oral health and dental services are the least affordable health services. This article also proposes how dental and general medical care coverage can be meaningfully integrated through better health policy to motivate health equity. DividedDental care services have a long history of being financed and delivered separately from medical care services. 1,2 In the mid-1800s, dental schools and associations were established independently of medical schools and associations. 1 Several important US health care reform milestones have reinforced this separation-most recently, the Affordable Care Act (ACA) of 2010. Under the ACA, dental care for adults was not included as an essential health benefit, and, while dental care for children was included and lowered total financial outlays, 3,4 the increase in stand-alone dental plans between 2014 and 2016 reinforced the separation of dental and medical insurance. 4 In this article, we summarize the implications of financing and delivering dental care separately from medical care, focusing on trends in outcomes and in affordability and utilization of dental care services and highlighting disparities by income, age, and race. We also pose some key questions for policymakers seeking to address these issues.

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