Aging Out of Coverage: Lessons from the West Virginia $1,000 Adult Dental Benefit

This paper studies the utilization of dental services during the recent implementation of an adult (age 21 and over) Medicaid dental benefit in West Virginia. We analyze claims data and find: 1) before implementation, quarterly utilization of preventative and restorative services falls from 8% at age 20 to virtually 0% at age 21; 2) post-implementation, utilization falls from 8% at age 20 to 5% at age 21, implying a net increase of 50% of baseline utilization; 3) the net effect of the dental benefit is significantly larger in counties with a larger number of oral health care provider practices. Our results provide evidence that public health insurance expansions are dampened in markets with a limited supply of provider practices.