Exploring the Impact of ACA on Rural-Urban Disparity in Oral Health Services Among US Noninstitutionalized Adults.

PURPOSE: To explore the effect of the Affordable Care Act (ACA) on rural disparities in oral health services utilization based on disability status. METHODS: Comparing the 2011-2013 with the 2014-2016 Medical Expenditure Panel Survey, the study estimated the impacts of ACA on the likelihood of having preventive checkup and utilization of dental treatments in adults older than 18. FINDINGS: The sample consists of 216,184 noninstitutionalized adults with 14.5% living in rural areas. There was a slight improvement in the receipt of oral health services after ACA, but the improvement was not statistically significant. Disability remains a barrier to receiving preventive oral health checkups, and living in rural areas is a barrier for both utilization of preventive checkups and dental treatments. CONCLUSIONS: Unmet needs for preventive checkups may result in unnecessary, costly dental treatments. More strategies are needed to reduce the disparities in oral health services.