Changes in Pediatric Dental Coverage and Visits Following the Implementation of the Affordable Care Act

Published in: Health Services Research, Volume 54, Issue 2, pages 437–445 (April 2019). doi: 10.1111/1475-6773.13093

Posted on on February 02, 2021

by Ashley M. Kranz, Andrew W. Dick


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.


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.

Research conducted by

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