The Big PictureRethinking dental coverage
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Background
The Affordable Care Act (ACA) has changed health care coverage for many Americans. Just 9.2% of Americans lack health insurance coverage, which is significantly less than before the ACA was put into effect. Coverage expansion through private health insurance and Medicaid has eased financial burdens on patients, health care costs are increasing at a much lower rate, and the share of out-of-pocket spending is falling. Thus the ACA has accomplished many of the objectives that were intended for it.
Facts to Consider
The percentage of Americans who have dental insurance is quite a bit lower than the percentage who have medical insurance. In addition, dental insurance coverage rates have risen dramatically for children, but the rates have fallen slowly for adult coverage. The steady increase in children's dental coverage rates has resulted from the expansion of Medicaid and the Children's Health Insurance Program rather than any expansion in private dental coverage. Children in low- and lower-middle class
What Needs to Change
Three areas that need to be addressed when rethinking dental insurance are as follows:
- 1.
Dental insurance should pay for the attainment of oral health and well-being rather than being tied to arbitrary dollar limits for procedures. Oral health outcomes can now be measured, and those measures should be used in determining payment. Outcome metrics should be applied to dentistry as in medicine.
- 2.
Dental insurance should incorporate risk by giving patients at high risk for oral disease a set of
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Vujicic M: Time to rethink dental “insurance.” J Am Dent Assoc 147:907-910, 2016
Reprints available from M Vujicic, Health Policy Inst, American Dental Assoc, 211 E Chicago Ave, Chicago, IL 60611; e-mail: [email protected]