# Investigating the Effects of Mandating Pediatric Oral Health Services as Essential Health Benefits

> **NIH NIH R03** · UNIVERSITY OF IOWA · 2020 · $154,500

## Abstract

Project Summary/Abstract
Recent national health reforms, including the Affordable Care Act (ACA), have devoted relatively little attention
to oral health despite the importance of oral health to overall health, particularly for children. A key factor in
improving oral health is expanding access to preventive dental care. Despite the limited attention overall, there
are several aspects of recent reforms that may affect oral health among children. Pediatric dental benefits are
treated as an essential health benefit (EHB) for private insurance plans for children 18 and under. To meet this
essential dental benefit objective states require that plans sold via private marketplaces either cover oral care
as part of medical coverage or that stand-alone dental plans with appropriate coverage be offered. There is no
requirement that the parent actually purchases the coverage, however, in the case of stand-alone dental plans,
making the evaluation of the mandate important from a policy perspective. Additionally, both Medicaid and
private marketplace insurance plans are required to provide a list of preventive services at no cost to patients.
For children 10 years of age and younger, oral health risk assessments are included in the list of required
preventive services. In terms of dental services, many states also go beyond these minimums and include
additional oral health services as part of qualified health plans (QHP). These oral health provisions of recent
national health reforms offer a unique opportunity to evaluate the effects of national and state coverage
mandates on take-up of dental coverage and use of preventive dental services among US children nationally.
The proposed study will identify the effects of oral health mandates for children under age 18 on dental
coverage and use of key preventive services. This study is highly innovative as it takes advantage of a national
policy potentially affecting millions of children. We can learn how effective mandates are in the context of child
dental coverage and use of dental services. Evidence from this study will contribute meaningful knowledge
about potential future policies tied to improving oral health among children and potentially among the broader
adult population. We plan to evaluate multiple preventive dental measures and dental treatments in addition to
assessing the effect on dental insurance coverage. We will further evaluate potential heterogeneity by
race/ethnicity, income levels, parental education, and rural/urban status. We will use a nationally
representative dataset to accomplish the proposed Specific Aims.

## Key facts

- **NIH application ID:** 9888398
- **Project number:** 5R03DE027756-02
- **Recipient organization:** UNIVERSITY OF IOWA
- **Principal Investigator:** Dan M Shane
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $154,500
- **Award type:** 5
- **Project period:** 2019-04-01 → 2022-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9888398

## Citation

> US National Institutes of Health, RePORTER application 9888398, Investigating the Effects of Mandating Pediatric Oral Health Services as Essential Health Benefits (5R03DE027756-02). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/9888398. Licensed CC0.

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