{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T14:08:27Z","timestamp":1777558107000,"version":"3.51.4"},"reference-count":40,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11,1]]},"abstract":"<jats:sec>\n                  <jats:title\/>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>BACKGROUND AND OBJECTIVES<\/jats:title>\n                  <jats:p>The Affordable Care Act required private insurers to cover a set of recommended preventive services without cost-sharing. This included coverage of fluoride varnish (FV) applications without cost-sharing for children aged 1 through 5 during medical visits, an evidence-based treatment that prevents tooth decay. We examined if this coverage mandate was associated with more young children receiving FV.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Using the Massachusetts All-Payer Claims Database (2014\u20132018), we examined the likelihood that a privately insured child received FV during a medical visit in a month. We used a difference-in-differences approach, comparing those included in the coverage mandate (aged 1\u20135) to those excluded from the mandate (aged 6\u20139), before and after the mandate was enacted (January 2015). We repeated analyses in children with Medicaid because this mandate may have had spillover effects for this population.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Among children aged 1 through 5 years with private insurance, 1-year postmandate the probability of FV receipt in a month increased 0.16 percentage points more relative to December 2014 (premandate) compared with the change among children aged 6 to 9 years (P &amp;lt; .001; 95% confidence interval = 0.1\u20130.22). When examining spillover to children with Medicaid, the mandate was not associated with a significant increase in the probability of monthly FV receipt 1-year postmandate.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>This Affordable Care Act mandate requiring coverage of FV without cost-sharing was associated with higher rates of young children receiving FV in medical settings, with the largest result observed among children with private insurance.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2024-066638","type":"journal-article","created":{"date-parts":[[2024,10,22]],"date-time":"2024-10-22T08:06:15Z","timestamp":1729584375000},"source":"Crossref","is-referenced-by-count":4,"title":["Affordable Care Act\u2019s Preventive Services Coverage Mandate and Receipt of Fluoride Varnish"],"prefix":"10.1542","volume":"154","author":[{"given":"Ashley M.","family":"Kranz","sequence":"first","affiliation":[{"name":"aRAND Corporation, Arlington, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuji","family":"Mizushima","sequence":"additional","affiliation":[{"name":"bRAND Corporation, Santa Monica, California"},{"name":"cPardee RAND Graduate School, Santa Monica, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew W.","family":"Dick","sequence":"additional","affiliation":[{"name":"dRAND Corporation, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimberley H.","family":"Geissler","sequence":"additional","affiliation":[{"name":"eDepartment of Healthcare Delivery and Population Sciences, UMass Chan Medical School-Baystate, Springfield, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tadeja","family":"Gracner","sequence":"additional","affiliation":[{"name":"bRAND Corporation, Santa Monica, California"},{"name":"fCenter for Economic and Social Research, University of Southern California, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2024,10,22]]},"reference":[{"key":"2024110102511572200_B1","unstructured":"Centers for Disease Control and Prevention. 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