Children's Health

Improving the design of Medicaid dental programs may lead to better oral health for poor children

Medicaid-insured children are more likely than uninsured children to visit a dentist in a given year but not as much as privately insured children, who are most likely to see a dentist. Richard J. Manski, D.D.S., M.B.A., Ph.D., and John F. Moeller, Ph.D., of the Agency for Healthcare Research and Quality, along with Burton L. Edelstein, D.D.S., M.P.H., of Columbia University, used data from AHRQ's Medical Expenditure Panel Survey to examine dental care coverage, use, and expenditures for U.S. children during 1996.

Half (52 percent) of children younger than age 18 had private dental coverage for at least part of 1996, and 56 percent of children living in poverty were covered by Medicaid for at least part of the year. Over half (56 percent) of children with private dental coverage made at least one dental visit during that year compared with 28 percent of uncovered children. Also, 28 percent of Medicaid-insured children made at least one dental visit compared with 19 percent of uninsured children. Overall, covered children obtained dental services at rates twice those of noncovered children at all income levels.

Only 56 percent of children residing in homes with $22,000 gross annual family income (for a family of four) had Medicaid dental coverage, somewhat lower than expected. Since children from the poorest households, especially the youngest children, are almost universally eligible for Medicaid, the relatively low level of dental coverage for low-income children may reflect a failure to enroll children rather than a lack of Medicaid availability itself. Small State-to-State differences in eligibility for Medicaid coverage and relative lack of access to Medicaid dental providers also may have contributed to this lower-than-expected rate of coverage, conclude the authors.

More details are in "The impact of insurance coverage on children's dental visits and expenditures, 1996," by Drs. Manski, Edelstein, and Moeller, in the August 2001 Journal of the American Dental Association 132, pp. 1137-1145.

Reprints (AHRQ Publication No. 01-R083) are available from the AHRQ Publications Clearinghouse.

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