Effects of Expanding Medicaid Dental Coverage on General Health Status of Low-Income Adults.

Background: Oral health is considered a key component of general health. However, causal evidence examining the effects of dental coverage on general health is sparse.

Objectives: To examine the effects of the Affordable Care Act (ACA) Medicaid expansions with extensive dental benefits versus less generous dental benefits on the general health status of individuals with low income.

Research design: A difference-in-differences design comparing states that expanded Medicaid eligibility in 2014 by whether they offered extensive or less generous dental benefits.

Subjects: Adults aged 18-64 years below 138% of the federal poverty level who participated in the 2011-2022 Behavioral Risk Factor Surveillance System surveys.

Outcome measures: Self-rated general health status and number of days not in good physical health or good mental health in the past 30 days.

Results: The likelihood of fair/poor rated health status declined with extensive dental benefits, including by 2.3 (95% CI: -3.90 to -0.69) percentage-points when aggregating 2014-2022, with declines first observed in 2015 and almost all years after. There were no statistically significant effects on days not in good physical or mental health when aggregating 2014-2022. There were fewer mentally unhealthy days with extensive dental benefits by 0.93 days in 2019 and 2021 (95% CI: -1.80 to -0.06 and -1.70 to -0.15, respectively).

Conclusion: The findings suggest that extensive dental coverage improves self-rated general health status among low-income adults. There is suggestive evidence of improved mental health in 2 but not all years and no discernable effect on days not in good physical health.