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Open Access The Affordable Care Act and Health Insurance Exchanges: Effects on the Pediatric Dental Benefit

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Purpose: To examine the relationship between state health insurance Exchange selection and pediatric dental benefit design, regulation and cost. Methods: Medical and dental plans were analyzed across three types of state health insurance Exchanges: State-based (SB), State-partnered (SP), and Federally-facilitated (FF). Cost-analysis was completed for 10,427 insurance plans, and health policy expert interviews were conducted. One-way ANOVA compared the cost-sharing structure of stand-alone dental plans (SADP). T-test statistics compared differences in average total monthly pediatric premium costs. Results: No causal relationships were identified between Exchange selection and the pediatric dental benefit's design, regulation or cost. Pediatric medical and dental coverage offered through the embedded plan design exhibited comparable average total monthly premium costs to aggregate cost estimates for the separately purchased SADP and traditional medical plan (P=0.11). Plan designs and regulatory policies demonstrated greater correlation between the SP and FF Exchanges, as compared to the SB Exchange. Conclusions: Parameters defining the pediatric dental benefit are complex and vary across states. Each state Exchange was subject to barriers in improving the quality of the pediatric dental benefit due to a lack of defined, standardized policy parameters and further legislative maturation is required.

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Keywords: AFFORDABLE CARE ACT; INSURANCE; PEDIATRIC DENTISTRY

Document Type: Research Article

Affiliations: 1: Private practice, Tulsa, Okla., USA. [email protected] 2: Division of Pediatric Dentistry and Community Oral Health, College of Dentistry, The Ohio State University, Columbus, Ohio, USA 3: Department of Pediatric Dentistry, Texas A&M Baylor College of Dentistry, Dallas, Texas, USA 4: Private practice, Huntington Beach, Calif., USA 5: American Academy of Pediatric Dentistry, Chicago, Ill. USA

Publication date: 01 January 2015

More about this publication?
  • Pediatric Dentistry is the official publication of the American Academy of Pediatric Dentistry, the American Board of Pediatric Dentistry and the College of Diplomates of the American Board of Pediatric Dentistry. It is published bi-monthly and is internationally recognized as the leading journal in the area of pediatric dentistry. The journal promotes the practice, education and research specifically related to the specialty of pediatric dentistry. This peer-reviewed journal features scientific articles, case reports and abstracts of current pediatric dental research.
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