Dental coverage for patients with Medicaid may not prevent tooth-related ER visits



Although the expansion of Medicaid under the Affordable Care Act has made millions of low-income and rural Americans eligible for health insurance, many states don’t provide dental coverage for adults under their Medicaid programs.

Paying for dental insurance on the individual market or paying for dental services out of pocket is cost-prohibitive for Medicaid beneficiaries, many of whom are at or beneath the federal poverty level.

So many have turned to emergency rooms for such care.

More than 2 percent of all emergency department visits are now related to nontraumatic dental conditions, according to a study by researchers at Stanford University, the University of California-San FranciscoTruven Health Analytics and the federal Agency for Healthcare Research and Quality.

The researchers said Medicaid dental coverage could help reduce the need for many low-income Americans to visit emergency departments for dental conditions that may have otherwise been prevented with adequate access to basic dental care.

“It is likely that EDs will continue to provide care to individuals without adequate access to community-based dental care unless new dental service delivery models are developed to expand access in underserved areas, and unless more dental providers begin to accept Medicaid under the ACA,” the researchers wrote in their study, which was published today in Health Affairs.


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