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Research by ADA Health Economists Shows Massachusetts Health Reform Increased Adults’ Access to Dental Care

September 09, 2013

Contact Information:
Rob Raible: Telephone: 202.789.5166 Email:
Richard Green: Telephone: 202.789.5170 Email:

Among the outcomes of Massachusetts’ 2006 health reform law, access to dental care for adults increased significantly, especially among poor adults, according to new research by health economists at the American Dental Association's Health Policy Resources Center (HPRC).

In an article published in the September 2013 issue of Health Affairs, health economists Kamyar Nasseh, PhD, and Marko Vujicic, PhD, examine the effects on adults’ access to dental care in Massachusetts between 2004 and 2010 in the wake of that state’s health care reform.

"The law had a particularly strong impact on poor adults, who became eligible for enhanced dental benefits through both MassHealth, the state’s Medicaid program, and through the health insurance marketplace," said Dr. Nasseh. "Dental care use among that group jumped 11 percentage points between 2004 and 2010."

The authors comment that even though the federal Affordable Care Act largely ignored dental benefits for adults, the experiences in Massachusetts and elsewhere show that states have ample policy options available to enhance access to dental care.

"The ADA has long advocated for mandated dental benefits for all Medicaid recipients—adults and children—as one important strategy to improve access to care for low-income Americans," said ADA President Robert A. Faiella, DMD, MMSc. "Congress missed a terrific opportunity to address this in the Affordable Care Act. Low-income adults were essentially left behind."

The failure of the ACA to address the critical dental needs of low-income adults was one impetus for the ADA’s launch of Action for Dental Health: Dentists Making a Difference, a major campaign to take on a mounting dental health crisis in America. The campaign comprises multiple initiatives that fall into three general areas:

• Providing care now to people already suffering with untreated disease;
• Strengthening and expanding the public-private safety net to provide more care to more Americans; and
• Bringing dental health education and disease prevention into communities.

Drs. Nasseh and Vujicic cite their work as clearly demonstrating that expanding dental benefits within Medicaid increased access to dental care for a largely neglected population.

"In conjunction with increased patient and provider outreach, enhanced provider incentives and streamlined administrative processes, it’s a highly effective strategy," said Dr. Vujicic, HPRC managing vice president.

"The lack of comprehensive dental care for adults is a glaring omission from the Affordable Care Act and from most state Medicaid programs," said Dr. Faiella. "Massachusetts has demonstrated that affordable coverage is possible in every state. The members of the ADA, along with numerous other groups and individuals, are committed to helping more states bridge the dental divide."

Advance copies of the article are available on request.

HPRC research on such other oral health policy issues as trends in adults’ and children’s access to care, the use of hospital emergency rooms by patients with dental pain, and the impact of the Affordable Care Act on the dental care system can be found at the Health Policy Resources Center.

About the ADA

The not-for-profit ADA is the nation's largest dental association, representing 163,000 dentist members. The premier source of oral health information, the ADA has advocated for the public's health and promoted the art and science of dentistry since 1859. The ADA's state-of-the-art research facilities develop and test dental products and materials that have advanced the practice of dentistry and made the patient experience more positive. The ADA Seal of Acceptance long has been a valuable and respected guide to consumer dental care products. The monthly The Journal of the American Dental Association (JADA) is the ADA's flagship publication and the best-read scientific journal in dentistry. For more information about the ADA, visit For more information on oral health, including prevention, care and treatment of dental disease, visit the ADA's consumer website