Abstract
The goal of the Patient Protection and Affordable Care Act (ACA) is to increase access to health insurance and decrease health care cost while improving health care quality. With more articles examining the relationship between one of the ACA provisions and dental health outcomes, we systematically reviewed the effect of the ACA on dental care coverage and access to dental services. We searched literature using the National Library of Medicine’s Medline (PubMed) and Thomson Reuters’ Web of Science between January 2010 and November 2020. We identified 33 articles related to dental coverage, and access/utilization of dental care services. This systematic review of studies showed that the ACA resulted in gains in dental coverage for adults and children, whereas results were mixed with dental care access. Overall, we found that the policy led to a decrease in cost barriers, an increase in private dental coverage for young adults, and increased dental care use among low-income childless adults. The implementation of the ACA was not directly associated with dental insurance coverage among people in the U.S. However, results suggest positive spillover effects of the ACA on dental care coverage and utilization by people in the national level dataset.
Highlights
For dental care coverage and utilization, most studies used survey data with a representative sample corresponding with the U.S population, including the Behavioral Risk Factor Surveillance System (BRFSS), the National Health Interview Survey (NHIS), the Medical Expenditure Panel Survey (MEPS), and the Gallup Healthways Wellbeing Index Survey
Assessing the impact of the Affordable Care Act (ACA) on dental care use is challenging because the law did not directly apply to dental insurance coverage
The ACA supported Medicaid expansion and most states that participated in Medicaid expansion had more of its residents covered for all Medicaid services including dental services [24]
Summary
The law included some of the most significant changes to the health care system in U.S. history. The goal of the ACA is to increase peoples’ access to health insurance and decrease health care costs while improving health care quality. Several examples include: insurance providers cannot deny and must provide a plan to individuals who have pre-existing conditions; companies who hire 50 or more full time employees must offer health insurance coverage; and individuals who do not have employer-sponsored insurance must buy health insurance through health insurance in the marketplace or pay a penalty (individual mandate). The ACA required ten essential health benefits that would ensure health plans cover care that patients need. Health plans must cover maternity and new born care, mental health and substance use disorder services and preventive and wellness services, and must offer pediatric dental care and vision services [1].
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