The Effect of State Health Insurance Selection on the Pediatricral Health Benefit
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To compare the impact of health care reform on the pediatric dental benefit across state health insurance Exchanges through the focused evaluation of (1) existing plan designs, (2) legislative processes through which these plans are selected and regulated, and (3) the role of the pediatric dental profession. Three states were selected based on type of Exchange implemented, identified as State-Based (SB), State-Partnered (SP), and Federally-Facilitated (FF). Data were collected through public record investigation and health policy expert interviews. A cost-analysis was completed for a total of 10,427 insurance plans from the three states. Sixteen confidential health policy expert interviews were conducted at state and federal levels. Individual monthly premium costs for embedded plans were found to have minimal differences when compared to the combined monthly premium costs of medical plans and stand-alone dental plans purchased separately (p=0.11). Financial implications of cost-sharing designs for embedded plans are limited, restricting consumer protections for the dental patient in comparison to medical coverage. Policy change for the federal regulation of dental insurance is markedly more challenging than for medical insurance given existing barriers resultant from the historical separation of the dental insurance industry from traditional medical insurance. Despite comparable premium costs across varying plan designs, the true affordability and quality of the state’s pediatric dental benefit requires greater transparency and consistent policy standards.
Orynich, Catherine Ashley (2014). The Effect of State Health Insurance Selection on the Pediatricral Health Benefit. Master's thesis, Texas A & M University. Available electronically from