Dentists reluctant to treat children on Medicaid, study finds

Not all health insurance is created equal: Dentists are far less willing to treat children with public health insurance than they are for children with private health coverage, according to a new study.

The findings, published online Monday in the journal Pediatrics, found that children on Medicaid were 38 times more likely to be denied any appointment by dentists who were not enrolled in Medicaid and the Children’s Health Insurance Program -- and were still 18 times more likely to be rejected by even those dentists who did accept Medicaid insurance.

Researchers led by Joanna Bisgaier of the University of Pennsylvania in Philadelphia trained six women to pretend to be the mother of a 10-year-old boy who had fallen off his bike and chipped his front tooth. They called up 85 dental offices in Cook County in Illinois, about half of whom participated in Medicaid and accepted Medicaid insurance. They called each one twice (for a total of 170 calls), and each time they told the same story -- with one key difference. In one call, they said they had Blue Cross insurance. In the other, they said they were on Medicaid.

Of all 170 calls, only 36.5% of the Medicaid-insured mothers managed to get any kind of appointment. Compare that with the Blue Cross-covered mothers, who got an appointment 95.4% of the time.

Why the prejudice against the publicly insured? The study authors cite a lot of potential reasons: “low fees, less patient compliance, negative attitudes toward beneficiaries, and administrative requirements being too burdensome. There also is literature on dentists’ unwillingness to treat certain populations, including young children, patients with developmental disabilities, and patients living with HIV/AIDS,” they write. So this safety net for those who can’t afford private insurance may not be as safe as once thought.

Why do you think there’s such a disparity? Post your thoughts below.

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