Blog | June 20, 2018
Medicaid expansion and oral health

This year marks the 8th anniversary of the passage of the Affordable Care Act (ACA). While it’s not perfect, there is no denying that the ACA has helped to reduce health disparities and saved lives by extending coverage to millions of Americans.

Nationwide, the uninsured rate dropped from 17 percent in 2009 to 8.8 percent in 2016, according to a Kaiser Health News report. Even more importantly, studies have found that expanded coverage also has reduced health disparities, with the ACA significantly improving “access to care for those who gained coverage.”

In Washington State, the ACA has helped to expand medical and dental coverage for hundreds of thousands of residents. The state’s uninsured rate dropped from 14 percent pre-ACA to less than 6 percent in 2017, due in large part to more than 581,000 lower-income adults gaining coverage through Medicaid expansion. More rural counties benefited the most, with Adams, Yakima and Pacific counties experiencing the most substantial gains in health and dental care coverage since the ACA.

Today, the state’s health benefit exchange serves one-quarter of Washington residents with private insurance or Apple Health (Medicaid). Dental coverage is included for all children up to age 19 who get insurance through the state’s health benefit exchange. Adults with Apple Health coverage also have comprehensive oral health care coverage, providing dental insurance for essential preventive dental care and early treatment.

The ACA has helped to expand coverage for vulnerable and at-risk individuals, but more work needs to be done to ensure that people experiencing the highest risk of oral disease get the care they need to live healthier.

People of color, and people living in rural communities and lower-income adults face the greatest barriers to accessing care, and reducing oral health disparities would improve health outcomes, quality of life and socio-economic mobility, said Kristen West, Senior Director of Programs and Policy for Arcora Foundation.

“Expanding dental coverage keeps people healthy,” West said. “Arcora Foundation is committed to decreasing oral health disparities through advocacy, grants, strategic partnerships through Local Impact Networks, and public awareness because good oral health care is essential to overall health.”

Painful oral disease and visible decay can impact chronic disease management, general wellness and nutrition. Poor oral health also can affect school attendance, employment opportunities and social engagement.

Continued advocacy is needed as the ACA faces uncertainty, affecting people in this state and throughout the country. Larry Leavitt of the Kaiser Family Foundation sums it: “The evidence is clear, people without insurance get less care, end up sicker and, frankly, die sooner.”

The effects of the ACA in Washington state include:

• More than 600,000 adults have enrolled in Apple Health, which includes dental benefits, through Medicaid expansion.
• More than 27,000 adults have received cancer treatment while enrolled under Medicaid expansion.
• In 2015, about 90,000 adults received treatment for substance use disorder services.
• The state’s health benefit exchange serves one-quarter of Washington residents with private insurance or Medicaid.
• The uninsured rate has dropped from 14 percent pre-ACA to less than 6 percent.
• You can learn more about how the ACA and Medicaid Expansion has helped people throughout the state here.