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Access to Dental Care in Medicaid: Spotlight on Nonelderly Adults

Issue Brief
  1. U.S. Department of Health and Human Services, Oral Health in America: A Report of the Surgeon General (Rockville, MD: U.S. Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutes of Health, 2000), http://www.nidcr.nih.gov/DataStatistics/SurgeonGeneral/Documents/hck1ocv.@www.surgeon.fullrpt.pdf.

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  2. Ibid.

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  3. Kaiser Commission on Medicaid and the Uninsured, Medicaid Benefits Database, 2010 Smith V., Gifford, K, and Ellis, E, et al, Moving Ahead Amid Fiscal Challenges: A Look at Medicaid Spending, Coverage and Policy Trends. Kaiser Commission on Medicaid and the Uninsured, October 2011.

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  4. US Department of Health and Human Services, Oral Health in America: A Report of the Surgeon General (Rockville, MD: U.S. Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutes of Health, 2000), http://www.nidcr.nih.gov/DataStatistics/SurgeonGeneral/Documents/hck1ocv.@www.surgeon.fullrpt.pdf.

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  5. Ibid.

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  6. Ibid.

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  7. Centers for Disease Control and Prevention, Oral Health for Adults (Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, July 2013), http://www.cdc.gov/oralhealth/publications/factsheets/adult_oral_health/adults.htm.

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  8. Ibid.

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  9. Bruce A. Dye et al., Dental caries and tooth loss in adults in the United States, 2011–2012. NCHS data brief, no 197 (Hyattsville, MD: National Center for Health Statistics, 2015, NHANES), http://www.cdc.gov/nchs/data/databriefs/db197.htm.

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  10. Melissa Majerol, Vann Newkirk, and Rachel Garfield, The Uninsured: A Primer, Key Facts about Health Insurance and the Uninsured in the Era of Health Reform: Supplemental Tables, (Washington, DC: Kaiser Commission on Medicaid and the Uninsured, Nov. 2015), http://kff.org/uninsured/report/the-uninsured-a-primer-key-facts-about-health-insurance-and-the-uninsured-in-the-era-of-health-reform/.

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  11. The Kaiser Family Foundation State Health Facts. Data Source: Kaiser Family Foundation estimates based on the Census Bureau's March 2014 and March 2015 Current Population Surveys (CPS: Annual Social and Economic Supplements), “Uninsured Rates for the Nonelderly by Federal Poverty Level (FPL)” accessed Feb. 26, 2016, http://kff.org/uninsured/state-indicator/rate-by-fpl/.

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  12. Rachel Garfield and Anthony Damico, The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid – An Update, (Washington, DC: Kaiser Commission on Medicaid and the Uninsured, Jan. 2016), http://kff.org/health-reform/issue-brief/the-coverage-gap-uninsured-poor-adults-in-states-that-do-not-expand-medicaid-an-update/.

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  13. Pub. L. 111-148, 124 Stat. 782 (2010) § 1302(b)(1) (codified at 42 U.S.C. § 18022(b)(1)) - Essential health benefits requirements

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  14. Centers for Medicare and Medicaid Services, “Alternative Benefit Plan Coverage” accessed Feb. 25, 2016, https://www.medicaid.gov/medicaid-chip-program-information/by-topics/benefits/alternative-benefit-plans.html.

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  15. Center for Health Care Strategies, Medicaid Adult Dental Benefits: An Overview (Hamilton, NJ: Center for Health Care Strategies, Oct. 2015), http://www.chcs.org/media/Adult-Oral-Health-Fact-Sheet_101915.pdf.

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  16. Medicaid and CHIP Payment and Access Commission, June 2015 Report to Congress on Medicaid and CHIP, Chapter 2: Medicaid Coverage of Dental Benefits for Adults, (Washington, DC: Medicaid and CHIP Payment and Access Commission, June 2015), https://www.macpac.gov/publication/coverage-of-medicaid-dental-benefits-for-adults-3/.

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  17. Carol Pryor and Michael Monopoli, Eliminating Adult Dental Coverage in Medicaid: An Analysis of the Massachusetts Experience, (Washington, DC: Kaiser Commission on Medicaid and the Uninsured, Aug. 2005), http://kff.org/medicaid/report/eliminating-adult-dental-coverage-in-medicaid-an/.

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  18. Neal T. Wallace et al., “The Individual and Program Impacts of Eliminating Medicaid Dental Benefits in the Oregon Health Plan,” American Journal of Public Health 101, no.11 (Nov. 2011): 2144-2150, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3222412/.

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  19. Medicaid and CHIP Payment and Access Commission, June 2015 Report to Congress on Medicaid and CHIP, Chapter 2: Medicaid Coverage of Dental Benefits for Adults, (Washington, DC: Medicaid and CHIP Payment and Access Commission, June 2015), https://www.macpac.gov/publication/coverage-of-medicaid-dental-benefits-for-adults-3/.

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  20. Cassandra Yarbrough, Kamyar Nasseh, and Marko Vujicic, Why Adults Forgo Dental Care: Evidence from a National Survey, (Chicago, IL: American Dental Association, Health Policy Institute, Nov. 2014), http://www.ada.org/~/media/ADA/Science%20and%20Research/HPI/Files/HPIBrief_1114_1.ashx

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  21. Kamyar Nasseh and Marko Vujicic, Dental Care Utilization Rate Continues to Increase among Children, Holds Steady among Working-Age Adults and the Elderly, (Chicago, IL: American Dental Association, Health Policy Institute, Oct. 2015), http://www.ada.org/~/media/ADA/Science%20and%20Research/HPI/Files/HPIBrief_1015_1.ashx.

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  22. Adele Sharter and Genevieve M. Kenney, QuickTake: The Forgotten Health Care Need: Gaps in Dental Care for Insured Adults Remain under ACA, (Washington, DC: Urban Institute, Sept. 2015), http://hrms.urban.org/quicktakes/Gaps-in-Dental-Care-for-Insured-Adults-Remain-under-ACA.html.

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  23. Bureau of Health Workforce, Health Resources and Services Administration (HRSA), Designated Health Professional Shortage Areas Statistics, as of January 1, 2016, (Washington, DC: U.S. Department of Health and Human Services, Health Resources and Services Administration, Feb. 2016), http://datawarehouse.hrsa.gov/tools/hdwreports/reports.aspx.

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  24. The National Conference of State Legislatures, Access to Oral Health Services for Low-Income People: Policy Barriers and Opportunities for Intervention for the Robert Wood Johnson Foundation, (Washington, DC: The National Conference of State Legislatures, Oct. 2002), http://www.ncsl.org/Portals/1/documents/health/forum/rwjoral.pdf.

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  25. Vernon K. Smith et al., Medicaid Reforms to October 2015 Expand Coverage, Control Costs and Improve Care: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2015 and 2016, (Washington, DC: Kaiser Commission on Medicaid and the Uninsured, Oct. 2015),  http://kff.org/medicaid/report/medicaid-reforms-to-expand-coverage-control-costs-and-improve-care-results-from-a-50-state-medicaid-budget-survey-for-state-fiscal-years-2015-and-2016/.

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  26. Peter Shin et al., Health Center Patient Trends, Enrollment Activities, and Service Capacity: Recent Experience in Medicaid Expansion and Non-Expansion States, (Washington, DC: Kaiser Commission on Medicaid and the Uninsured, Dec. 2015), http://kff.org/report-section/health-center-patient-trends-enrollment-activities-and-service-capacity-issue-brief/.

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  27. Ibid.

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  28. Health Resources and Services Administration (HRSA), 2014 Health Center Profile: Uniform Data System, (Washington, DC: U.S. Department of Health and Human Services, Health Resources and Services Administration), http://www.bphc.hrsa.gov/datareporting/index.html.

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  29. Ryan K. Edmunds, “Increasing Access to Care with Diversity,” Journal of Dental Education 70, no. 9 (Sept. 2006): 918-920, http://www.ncbi.nlm.nih.gov/pubmed/16954412.

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  30. Allan J. Formicola et al., “Underrepresented Minority Dental Student Recruitment and Enrollment Programs: An Overview from the Dental Pipeline Program,” Journal of Dental Education 74, no. 10, 10 suppl. (Oct. 2010): S67-S73, http://www.jdentaled.org/content/74/10_suppl/S67.full.

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  31. Bryan Kelley, NCSL Blog: Maine Introduces Mid-Level Dental Providers to Increase Access to Care (Washington, DC: National Conference of State Legislatures, May 2014), http://www.ncsl.org/blog/2014/05/06/maine-introduces-mid-level-dental-providers-to-increase-access-to-care.aspx.

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  32.   The Pew Charitable Trusts, Working with Midlevel Providers: Dentists' Perspectives, (Washington, DC:  The Pew Charitable Trusts, Oct. 2014), http://www.pewtrusts.org/en/research-and-analysis/analysis/2014/10/02/working-with-midlevel-providers-dentists-perspectives.

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  33. Rachel Yalowich and Chiara Corso, Enhancing Oral Health Access through Safety Net Partnerships: A Primer and Resource Guide for Medicaid Agencies, (Washington, DC: National Academy for State Health Policy, Aug. 2015), http://www.nashp.org/wp-content/uploads/2015/08/Enhancing-Oral-Health-Primer-for-Medicaid-Agencies.pdf.

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  34. Jane Koppelman, Opinion: Expanding Access through Midlevel Dental Providers, (Washington, DC: The Pew Charitable Trusts, Nov. 2015), http://www.pewtrusts.org/en/about/news-room/opinion/2015/11/17/expanding-access-through-midlevel-dental-providers.

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  35. Daniela Hernandez, California To Launch Medicaid-Funded Teledentistry, (Washington, DC: Kaiser Health News, Sept. 2014), http://khn.org/news/california-to-launch-medicaid-funded-teledentistry/.

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  36. Pacific Center for Special Care, Policy Brief: The Virtual Dental Home: Improving the Oral Health of Vulnerable and Underserved Populations Using Geographically Distributed Telehealth-enabled Teams (San Francisco, CA: University of the Pacific, Arthur A. Dugoni School of Dentistry, Pacific Center for Special Care, May 2013), http://dental.pacific.edu/Documents/community/special_care/acrobat/VirtualDentalHome_OvierviewResults_PolicyBrief_May_2013.pdf.

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  37. Taressa Fraze et al., Research Brief: Early Insights on Dental Care Services in Accountable Care Organizations, (Chicago, IL: American Dental Association, Health Policy Institute, April 2015), http://www.ada.org/~/media/ADA/Science%20and%20Research/HPI/Files/HPIBrief_0415_1.ashx.

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  38. Ibid.

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  39. Michelle Hurlbutt, CAMBRA: Best Practices in Dental Caries Management, (Chesterland, OH: Academy of Dental Therapeutics and Stomatology, Aug. 2011), http://www.rdhmag.com/etc/medialib/new-lib/rdh/site-images/volume-31/issue-10/1110RDH095-109.pdf.

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  40. Andrew Snyder and Keerti Kanchinadam, Adult Dental Benefits in Medicaid: Recent Experiences from Seven States (Washington, DC: National Academy for State Health Policy, July 2015), http://www.nashp.org/wp-content/uploads/2015/07/Adult-Dental-Benefits-in-Medicaid-Recent-Experiences-from-Seven-States.pdf.

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