Medicaid Expansion Under ACA Boosts Dental Visits for Foreign-Born Without Raising Costs

This study analyzed the effects of the Affordable Care Act (ACA) Medicaid expansion on dental visit frequency and expenditures among key U.S. subpopulations: military veterans, older adults aged 65 and older, and foreign-born individuals.

Using 2012-2016 Medical Expenditure Panel Survey data, the research applied logistic and two-part regression models to assess dental care utilization and spending in states that expanded Medicaid compared to those that did not. The difference-in-differences approach found a significant increase in dental visits among the foreign-born in Medicaid expansion states, with a 17% higher odds of having had a dental visit post-expansion.

However, dental visit changes among veterans and older adults were not statistically significant. Despite increased dental visits among the foreign-born, per capita dental expenditures showed no significant rise across any groups, indicating cost containment alongside expanded access.

The study emphasizes the importance of Medicaid expansion in reducing access barriers for vulnerable populations, particularly immigrants, while controlling associated costs. Given these findings, public health policy should consider prioritizing Medicaid dental benefits to support improved preventive and dental care access.

The results also dispel concerns that Medicaid expansion drives unsustainable rises in dental spending. Limitations include reliance on survey data restricted to the civilian noninstitutionalized population and potential residual confounding. Future longitudinal studies are recommended to monitor dental care trends and expenditures over time. This analysis contributes valuable insights for policymakers, payers, and health system planners focused on equity in oral health access, cost containment, and Medicaid policy implementation.