Low rates of pediatric dental coverage for families purchasing marketplace insurance plans

J Public Health Dent. 2019 Dec;79(4):275-278. doi: 10.1111/jphd.12332. Epub 2019 Aug 13.

Abstract

Objectives: Pediatric dental care is an essential health benefit that the Affordable Care Act (ACA) requires most private health plans to cover. Insurance marketplaces have flexibility in how pediatric dental coverage is offered, with states requiring purchase of dental coverage or embedding dental coverage in all medical plans. It is unknown how these different offerings may affect uptake of coverage.

Methods: We analyzed the 2014-2015 National Health Interview Survey to determine rates of private dental coverage for children obtaining private medical insurance from all state marketplaces (weighted N = 12,380).

Results: We found low rates of dental coverage for children in states where purchase of dental coverage was required (9%) and in states where all marketplace medical plans had embedded dental coverage (24%).

Conclusions: Few families obtaining private medical insurance on the marketplaces report having pediatric dental coverage, suggesting that the ACA essential health benefit policy may not be having its intended effect.

Keywords: child; child health; dental care for children; health insurance; insurance, dental; patient protection and affordable care act.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Child
  • Dental Care
  • Health Insurance Exchanges*
  • Health Policy
  • Humans
  • Insurance Coverage
  • Patient Protection and Affordable Care Act*
  • United States