Why each state should provide full Medicaid dental coverage for all adults, per ADA

Adult dental coverage via Medicaid improves access to and utilization of dental care and may reduce racial disparities, improve health equity and lower medical care costs, according to a research paper published by the American Dental Association.

Authors Marko Vujicic, PhD; Chelsea Fosse, DMD; Colin Reusch; and Melissa Burroughs estimate increased spending on dental care as well as medical care cost savings stemming from improved oral health if extensive dental coverage for adults was implemented by 28 state Medicaid programs that currently do not have coverage.

Seven key report takeaways:

1. As of early 2021, 21 states and Washington, D.C. provide extensive adult dental benefits via Medicaid. Sixteen states provide limited benefits, nine have emergency-only benefits, three provide no benefits and one has a dental benefit under development.

2. Dental care has the highest level of financial barriers compared to any other healthcare service. Factors such as lack of insurance and high costs are more limiting to dental care access than non-financial factors, such as fear of the dentist or challenges scheduling appointments.

3. Of all economic statuses, low-income adults are least likely to access dental care. They also are more likely to experience dental pain and find life less satisfying due to the condition of their mouth and teeth.

4. Black and Hispanic Americans are more likely to face cost barriers to dental care than their white peers, a disparity that has been increasing over time.

5. There is a clear link between Medicaid dental coverage for adults and cost barriers to dental care, oral health status and employability. Outcomes were most pronounced for Black Medicaid enrollees and those who had gone without dental coverage for more than a year.

6. Expanded coverage can reduce overall medical costs, with numerous studies finding dental coverage significantly reduces costly emergency department visits for dental conditions.

7. Across all 28 state Medicaid programs, the total cost of providing extensive dental coverage to adults is $836 million per year. This includes a projected $1.1 billion per year in dental care costs and $273 million per year in medical care savings.

"The fact that Medicaid adult dental coverage remains optional for states exacerbates deep racial and geographic disparities in access to oral healthcare and oral health outcomes," the authors wrote.

"The most straightforward way to address oral health access is through federal policy that makes comprehensive oral health coverage for adults a permanent part of the Medicaid program for all states," the authors concluded.

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