New data add to mounting evidence that expanding access to dental coverage for people with low incomes has wide-ranging benefits. Specifically, researchers in Michigan found that oral health coverage strengthened the health and employment – including job prospects and job performance – of low-income adults in the state. As state and federal policymakers seek to help communities recover in the wake of the COVID-19 pandemic, Medicaid expansion that includes dental care should be at the top of the list.
Thankfully, Michigan is among the 39 states and Washington, D.C. that have expanded Medicaid, a change made possible by the Affordable Care Act and newly bolstered by the American Rescue Plan Act. A University of Michigan team studied the impact of their state’s expansion, known as the Healthy Michigan Plan, on the lives of people who gained coverage. Pre-pandemic data show that from 2014 to 2019, nearly one million low-income adults in the state gained coverage. In Michigan, this coverage for adults includes key oral health services, such as preventive care, fillings and dentures.
In addition to reviewing Medicaid claims, researchers surveyed 4,090 people who had been enrolled in the Healthy Michigan Plan for at least one year. They also interviewed almost 70 people who had been enrolled for at least six months. One middle-aged man who was interviewed shared, “My teeth were pretty bad…and they fixed it up fine, and now…I feel better when I am looking for a job…I feel better because my appearance has changed a lot. That has helped me a lot, physically and mentally.”
Their stories spotlight the value of oral health care. Further, they speak to how greater dental access is key to advancing health equity and economic opportunities. These are crucial goals, coming out of a pandemic that has surfaced America’s deep health inequities, and which disproportionately set back the financial stability of Black, indigenous and other people of color, as well as people with low incomes.
First, opening the door to dental coverage is a critical part of helping people achieve good oral health. Michigan’s findings shows that six in ten people visited a dentist at least once since gaining their new coverage and more than half of them said such care improved their oral health. The share of people reporting better oral health was greater among Black adults and those who had been uninsured for at least a year before Medicaid expansion. These data make clear that broadening access to dental care is key to advancing health equity.
Second, policies that help people achieve better oral health can also bolster their employment. The study reports that six in ten unemployed people whose oral health improved after enrolling in Medicaid expansion said that gaining coverage helped them search for a job. This result is in line with other recent research that has found when struggling adults lack Medicaid dental coverage, six in ten say poor oral health makes it more difficult for them to find employment. Making oral health coverage accessible stands to strengthen the economic security of families and communities.
In addition to helping people seek employment, coverage may also help workers keep a job. More than three in four employed adults (76 percent) who attained better oral health said their new coverage also improved their job performance. We do better at work, and some can even earn more, when policies help us achieve better oral health.
However, in recent years, one in three adults has lacked oral health coverage; Medicaid dental coverage for adults is optional for states. There are several proposals in Congress to lift barriers to dental coverage for adults enrolled in Medicaid and other health programs. Further, as our blog recently noted, the American Rescue Plan Act provides new financial incentives for the 12 remaining states to adopt Medicaid expansion. With pandemic recovery on the horizon, policymakers have an opportunity to help more people return to work and rebuild businesses. This research shows Medicaid expansion and Medicaid adult dental benefits can support both of those goals, lifting hurdles to coverage and helping people to be healthier.
We urge state and federal lawmakers to take up these key solutions. The Healthy Michigan Plan study proves, once again, that Medicaid expansion and oral health coverage can drive significant health and economic gains. Given these benefits, it just makes sense to expand Medicaid and ensure oral health is part of that coverage.