The Patient Protection and Affordable Care Act and oral health care use among formerly incarcerated people in the United States

Abstract

Background: Formerly incarcerated people report less frequent oral health care use, despite having more substantial oral health problems. This study aimed to determine whether the adoption of the Patient Protection and Affordable Care Act (ACA) has improved oral health care use among formerly incarcerated people in the United States.

Method: Data were from Wave I (1994-1995), Wave IV (2008), and Wave V (2016-2018) of the National Longitudinal Study of Adolescent to Adult Health (n = 9,108), a nationally representative cohort study in the United States.

Results: On the basis of the results of multiple logistic regression analysis with interaction terms, the authors found a positive and statistically significant interaction between prior incarceration and living in a state with ACA adoption on past-year oral health care use, net of potential confounding variables (incarceration × ACA: odds ratio, 1.587; 95% CI, 1.043 to 2.414). Substantively, the findings suggest that people with a history of incarceration are less likely to use oral health care, and this disparity is more likely to occur in states without ACA adoption.

Conclusions: ACA adoption corresponds with improvements in the receipt of oral health care among formerly incarcerated people.

Practical implications: This study builds on prior evidence highlighting that the ACA is beneficial in connecting formerly incarcerated people to health care services and suggests that these benefits may extend to improving access to and use of oral health care.

Keywords: Add Health; Incarceration; Patient Protection and Affordable Care Act; dental care use; policy.