Modeling the Impact of COVID-19 on Dental Insurance Coverage and Utilization

Area of Science:

• Public Health
• Health Economics
• Dental Public Health

Background:

• The COVID-19 pandemic has triggered substantial economic disruption and rising unemployment in the U.S.
• Job losses frequently result in the loss of employer-sponsored dental insurance (ESDI), affecting millions of Americans.
• Changes in dental insurance coverage directly influence population oral health and access to dental care.

Purpose of the Study:

• To assess the impact of increased unemployment rates on dental insurance coverage and utilization.
• To estimate changes in dental insurance coverage at the state level.
• To project shifts in dental procedure types and emergency department visits for dental issues.

Main Methods:

• Econometric estimates were used to determine changes in state-level dental insurance coverage.
• A microsimulation model, utilizing national practice survey data, projected changes in dental procedures.
• Trendline analysis of emergency department visits by payer type estimated changes in dental-related ED visits.

Main Results:

• An 8.40 percentage point increase in unemployment is expected to cause over 16 million individuals to lose ESDI.
• Approximately 45% of those losing ESDI may enroll in Medicaid/CHIP, while 47% are projected to become uninsured.
• Dental practices anticipate fewer routine checkups and more tooth extractions; dental ED visits are predicted to increase by 4.0%.

Conclusions:

• Unemployment due to COVID-19 can negatively affect oral health by reducing access to dental care.
• States with non-expanded Medicaid or limited adult Medicaid dental benefits may experience more pronounced impacts.
• The findings highlight the vulnerability of dental care access tied to employment and insurance status.