The Role of Medicaid in Children’s Access to Dental Care

— This blog post is an excerpt from the Benevis Whitepaper “The Dental Divide and the Health Chasm It Creates for Too Many Children“ —

An estimated 74 million Americans—nearly a quarter of the population—have no dental insurance coverage. For comparison, that is well over double the estimated 28 million Americans who have no health insurance.*

For low-income families who are least likely to have dental coverage, the cost of dental care can be a major deterrent. They may avoid or delay seeking care for themselves and their children because they cannot afford to pay for it. Joint federal-state programs help to bridge the gap for many families.

About 40% of children between the ages of 2-18 have dental benefits through Medicaid or the Children’s Health Insurance Program (CHIP). These phenomena result in significant deficiencies in access to care.

While greater coverage is a positive, the reimbursement rates for dentists are low for these programs. Rates vary widely state by state. On a national average, Medicaid and CHIP programs pay just 61% of rates paid by private insurers for child dental health services. As a result, only 39% of U.S. dentists accept Medicaid or CHIP.***

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SOURCES
*U.S. Census Bureau: Health Insurance Coverage in the United States: 2020.” Sept. 14, 2021.

**American Dental Association: Reimbursement Rates for Child and Adult Dental Services in Medicaid by State infographic. ADA Health Policy Institute, October 2021.
***The Center for Health Care Strategies, Inc.: “Medicaid Adult Dental Benefits: An Overview.” September 2019.