The United States is once again experiencing a steady wave of state health reforms intended to cover more uninsured people, restrain rising costs, improve health outcomes, and redistribute financial burdens. Maine, Massachusetts, and Vermont were at the forefront in crafting broad, ambitious reforms and are well along in the implementation process. In many other states, including Kansas, plans are in motion or legislation is being crafted.
Most attention is being focused on the impact of state reforms on the private insurance market and the benefits of increased insurance coverage and access to care. But many other questions have arisen. This paper answers a question posed by policy makers in Kansas: how can the state include dental benefits in a health care reform plan, should the state choose to do so? Unfortunately, none of the three pioneering states included dental benefits for the majority of their expansion populations, although they were maintained for poor populations in traditional Medicaid. The primary barrier for them at the outset was cost, although the traditional separation of general health and oral health – with a lesser importance ascribed to oral – was a factor.
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