LAUSR

Racial and ethnic disparities in adults' access to dental care have persisted for decades. We examined how recent Affordable Care Act Medicaid expansions that included coverage of dental services for adults affected racial and ethnic disparities in dental services use. Using Medical Expenditure Panel Survey data from the period 2011-18, we compared changes in dental services use for low-income non-Hispanic Black and Hispanic adults with changes in use for low-income non-Hispanic White adults. We found that expansions including extensive dental benefits were associated with narrowed racial and ethnic disparities in dental care visits and use of preventive and treatment services. For non-Hispanic Black and Hispanic adults, after Medicaid expansion with extensive dental benefits there was an 8-percentage-point increase in their likelihood of dental visits in a given year when compared with non-Hispanic White adults. This represents a reduction from preexpansion disparities by 75 percent for non-Hispanic Black adults and 50 percent for Hispanic adults. This disparity decline is due to both an increase in dental services use among non-Hispanic Black and Hispanic adults and little change occurring among non-Hispanic White adults. In contrast, no decline in disparities was seen in states with less generous dental benefits. Overall, rates of dental care among low-income adults continue to be low across racial and ethnic groups, indicating other key access barriers to dental care and persistent unmet oral health needs.