How Do Providers Respond to Public Health Insurance Expansions? Evidence from Adult Medicaid Dental Benefits

58 Pages Posted: 21 Apr 2014 Last revised: 18 Apr 2021

See all articles by Tom Buchmueller

Tom Buchmueller

University of Michigan - Stephen M. Ross School of Business

Sarah Miller

University of Notre Dame

Marko Vujicic

American Dental Association

Date Written: April 2014

Abstract

A large and growing number of adults are covered by public insurance, and the Affordable Care Act is predicted to dramatically increase public coverage over the next several years. This study evaluates how such large increases in public coverage affect provider behavior and patient wait times by analyzing a common type of primary care: dental services. We find that when states add dental benefit to adult Medicaid coverage, dentists' participation in Medicaid increases and dentists see more publicly insured patients without decreasing the number of visits provided to privately insured patients. Dentists increase the total number of visits they supply each week while only modestly increasing the amount of time they spend working. They achieve this primarily by making greater use of dental hygienists. As a result, dentists' income increases. Wait times increase modestly, with the largest increases in wait times observed in states with restrictive scope of practice laws governing dental hygienists. These changes are most pronounced among dentists who practice in poor areas where Medicaid coverage is greatest.

Suggested Citation

Buchmueller, Tom and Miller, Sarah and Vujicic, Marko, How Do Providers Respond to Public Health Insurance Expansions? Evidence from Adult Medicaid Dental Benefits (April 2014). NBER Working Paper No. w20053, Available at SSRN: https://ssrn.com/abstract=2427155

Tom Buchmueller (Contact Author)

University of Michigan - Stephen M. Ross School of Business ( email )

701 Tappan Street
Ann Arbor, MI MI 48109
United States

Sarah Miller

University of Notre Dame ( email )

361 Mendoza College of Business
Notre Dame, IN 46556-5646
United States

Marko Vujicic

American Dental Association ( email )

211 East Chicago Avenue
Chicago, IL 60611
United States

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