{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:21:19Z","timestamp":1787008879525,"version":"build-2736575974"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T00:00:00Z","timestamp":1690848000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006545","name":"NIMHD)","doi-asserted-by":"publisher","award":["R00MD012253"],"award-info":[{"award-number":["R00MD012253"]}],"id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000905","name":"Commonwealth Fund","doi-asserted-by":"publisher","award":["261487"],"award-info":[{"award-number":["261487"]}],"id":[{"id":"10.13039\/100000905","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The extent to which the COVID-19 pandemic has affected early changes in health coverage and access to dental care services in states that expanded Medicaid versus those that did not is currently not well known. Using data from the National Health Interview Survey, we found that, during the first year of the COVID-19 pandemic, states that had previously expanded their Medicaid programs under the Affordable Care Act had lower uninsurance rates for White low-income adults (\u22128.8 percentage points; 95% CI: \u221216.6, \u22121.0) and lower dental uninsurance rates for all low-income adults (\u22125.4 percentage points; 95% CI: \u221210.4, \u22120.5). Our findings also suggest that the combination of Medicaid expansion with coverage of adult dental benefits in Medicaid was associated with improved dental coverage and access to dental care during the pandemic. With the expiration of the public health emergency declaration, states are considering strategies to prevent disruptions in Medicaid coverage. Our study adds to the evidence of the importance of Medicaid expansion in stabilizing health coverage during a public health crisis.<\/jats:p>","DOI":"10.1093\/haschl\/qxad032","type":"journal-article","created":{"date-parts":[[2023,7,30]],"date-time":"2023-07-30T08:11:00Z","timestamp":1690704660000},"source":"Crossref","is-referenced-by-count":4,"title":["Early changes in health coverage and access to dental care associated with Medicaid expansion under the COVID-19 pandemic"],"prefix":"10.1093","volume":"1","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1351-4038","authenticated-orcid":false,"given":"Hawazin W","family":"Elani","sequence":"first","affiliation":[{"name":"Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine , Boston, MA 02115 , United States"},{"name":"Department of Health Policy and Management, Harvard T.H. Chan School of Public Health , Boston, MA 02115 , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3811-257X","authenticated-orcid":false,"given":"Jose F","family":"Figueroa","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Harvard T.H. Chan School of Public Health , Boston, MA 02115 , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ichiro","family":"Kawachi","sequence":"additional","affiliation":[{"name":"Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health , Boston, MA 02115 , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3410-0184","authenticated-orcid":false,"given":"Meredith","family":"Rosenthal","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Harvard T.H. Chan School of Public Health , Boston, MA 02115 , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,8,1]]},"reference":[{"key":"2023082523024243600_qxad032-B1","author":"Kaiser Family Foundation"},{"key":"2023082523024243600_qxad032-B2","volume-title":"Health Coverage Changes Under the Affordable Care Act: End of 2021 Update","author":"Lee","year":"2022"},{"issue":"10","key":"2023082523024243600_qxad032-B3","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1056\/NEJMsa1612890","article-title":"Health and access to care during the first 2 years of the ACA Medicaid expansions","volume":"376","author":"Miller","year":"2017","journal-title":"N Engl J Med"},{"issue":"6","key":"2023082523024243600_qxad032-B4","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1056\/NEJMsb1706645","article-title":"Health insurance coverage and health\u2014what the recent evidence tells us","volume":"377","author":"Sommers","year":"2017","journal-title":"N Engl J Med"},{"issue":"4","key":"2023082523024243600_qxad032-B5","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1111\/jphd.12257","article-title":"The impact of the Affordable Care Act's Medicaid expansion on dental care use through 2016","volume":"77","author":"Nasseh","year":"2017","journal-title":"J Public Health Dent"},{"issue":"11","key":"2023082523024243600_qxad032-B6","doi-asserted-by":"crossref","first-page":"1900","DOI":"10.1377\/hlthaff.2020.00386","article-title":"Changes in coverage and access to dental care five years after ACA Medicaid expansion","volume":"39","author":"Elani","year":"2020","journal-title":"Health Aff (Millwood)"},{"issue":"3","key":"2023082523024243600_qxad032-B7","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1111\/1475-6773.13261","article-title":"Changes in emergency department dental visits after Medicaid expansion","volume":"55","author":"Elani","year":"2020","journal-title":"Health Serv Res"},{"issue":"9","key":"2023082523024243600_qxad032-B8","doi-asserted-by":"crossref","first-page":"e2124144","DOI":"10.1001\/jamanetworkopen.2021.24144","article-title":"Dental outcomes after Medicaid insurance coverage expansion under the Affordable Care Act","volume":"4","author":"Elani","year":"2021","journal-title":"JAMA Netw Open"},{"issue":"5","key":"2023082523024243600_qxad032-B9","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1001\/jama.2020.12248","article-title":"COVID-19 and massive job losses will test the US health insurance safety net","volume":"324","author":"Levitt","year":"2020","journal-title":"JAMA"},{"key":"2023082523024243600_qxad032-B10","author":"Karpman"},{"issue":"8","key":"2023082523024243600_qxad032-B11","doi-asserted-by":"crossref","first-page":"e212007","DOI":"10.1001\/jamahealthforum.2021.2007","article-title":"COVID-19\u2013related insurance coverage changes and disparities in access to care among low-income US adults in 4 southern states","volume":"2","author":"Figueroa","year":"2021","journal-title":"JAMA Health Forum"},{"issue":"9","key":"2023082523024243600_qxad032-B12","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.1377\/hlthaff.2021.00377","article-title":"Association of unemployment with Medicaid enrollment by social vulnerability in North Carolina during COVID-19","volume":"40","author":"Shafer","year":"2021","journal-title":"Health Aff (Millwood)"},{"issue":"6","key":"2023082523024243600_qxad032-B13","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1111\/1475-6773.14029","article-title":"COVID-19-related Medicaid enrollment in Medicaid expansion and non-expansion states","volume":"57","author":"Benitez","year":"2022","journal-title":"Health Serv Res"},{"key":"2023082523024243600_qxad032-B14","author":"National Center for Health Statistics"},{"key":"2023082523024243600_qxad032-B15","volume-title":"Local Area Unemployment Statistics","author":"Bureau of Labor Statistics","year":"2021"},{"key":"2023082523024243600_qxad032-B16","author":"American Dental Association, Health Policy Institute"},{"issue":"5","key":"2023082523024243600_qxad032-B17","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1016\/S1473-3099(20)30120-1","article-title":"An interactive web-based dashboard to track COVID-19 in real time","volume":"20","author":"Dong","year":"2020","journal-title":"Lancet Infect Dis"},{"issue":"1","key":"2023082523024243600_qxad032-B18","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1162\/003355304772839588","article-title":"How much should we trust differences-in-differences estimates?","volume":"119","author":"Bertrand","year":"2004","journal-title":"Q J Econ"},{"key":"2023082523024243600_qxad032-B19"},{"issue":"5","key":"2023082523024243600_qxad032-B20","doi-asserted-by":"crossref","first-page":"e219463","DOI":"10.1001\/jamanetworkopen.2021.9463","article-title":"Changes in US Medicaid enrollment during the COVID-19 pandemic","volume":"4","author":"Khorrami","year":"2021","journal-title":"JAMA Netw Open"},{"issue":"10","key":"2023082523024243600_qxad032-B21","doi-asserted-by":"crossref","first-page":"1822","DOI":"10.1377\/hlthaff.2020.00900","article-title":"COVID-19 has increased Medicaid enrollment, but short-term enrollment changes are unrelated to job losses","volume":"39","author":"Frenier","year":"2020","journal-title":"Health Aff (Millwood)"},{"issue":"2","key":"2023082523024243600_qxad032-B22","doi-asserted-by":"crossref","first-page":"e214752","DOI":"10.1001\/jamahealthforum.2021.4752","article-title":"Trends in Medicaid enrollment and disenrollment during the early phase of the COVID-19 pandemic in Wisconsin","volume":"3","author":"Dague","year":"2022","journal-title":"JAMA Health Forum"},{"key":"2023082523024243600_qxad032-B23","author":"Solomon"},{"issue":"9","key":"2023082523024243600_qxad032-B24","doi-asserted-by":"crossref","first-page":"e212487","DOI":"10.1001\/jamahealthforum.2021.2487","article-title":"Trends in US health insurance coverage during the COVID-19 pandemic","volume":"2","author":"Bundorf","year":"2021","journal-title":"JAMA Health Forum"},{"issue":"1","key":"2023082523024243600_qxad032-B25","first-page":"100495","article-title":"Association of race, ethnicity, and community-level factors with COVID-19 cases and deaths across U.S. counties","volume":"9","author":"Figueroa","year":"2021","journal-title":"Healthcare (Amsterdam, Netherlands)"},{"issue":"11","key":"2023082523024243600_qxad032-B26","doi-asserted-by":"crossref","first-page":"e214608","DOI":"10.1001\/jamahealthforum.2021.4608","article-title":"Federal policies to expand health insurance coverage during the COVID-19 pandemic and beyond","volume":"2","author":"Sommers","year":"2021","journal-title":"JAMA Health Forum"},{"issue":"12","key":"2023082523024243600_qxad032-B27","doi-asserted-by":"crossref","first-page":"e201463","DOI":"10.1001\/jamahealthforum.2020.1463","article-title":"Delayed care with harmful health consequences\u2014reported experiences from national surveys during coronavirus disease 2019","volume":"1","author":"Findling","year":"2020","journal-title":"JAMA Health Forum"},{"issue":"7","key":"2023082523024243600_qxad032-B28","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1016\/j.adaj.2021.04.002","article-title":"To work toward oral health care equity, start with Medicaid","volume":"152","author":"Casamassimo","year":"2021","journal-title":"J Am Dent Assoc"},{"key":"2023082523024243600_qxad032-B29","author":"Dahlhamer"}],"container-title":["Health Affairs Scholar"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/healthaffairsscholar\/advance-article-pdf\/doi\/10.1093\/haschl\/qxad032\/51015411\/qxad032.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/healthaffairsscholar\/article-pdf\/1\/2\/qxad032\/51261880\/qxad032.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/healthaffairsscholar\/article-pdf\/1\/2\/qxad032\/51261880\/qxad032.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T19:02:59Z","timestamp":1692990179000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/healthaffairsscholar\/article\/doi\/10.1093\/haschl\/qxad032\/7234487"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,1]]},"references-count":29,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,8,2]]}},"URL":"https:\/\/doi.org\/10.1093\/haschl\/qxad032","relation":{},"ISSN":["2976-5390"],"issn-type":[{"value":"2976-5390","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,8]]},"published":{"date-parts":[[2023,8,1]]},"article-number":"qxad032"}}