Affordable Care Act: Improved health, lower costs in youth with dependent coverage

1. The Affordable Care Act mandates extended parental insurance coverage to children under age 26. 

2. Under the provision, the new group of insurees reported better physical and mental health, had greater percentage of coverage, and decreased out-of-pocket healthcare expenditures. 

Evidence Rating Level: 2 (Good) 

Study Rundown: One of the most touted aspects of the Affordable Care Act (ACA) is its provision to extend parental insurance to young adults until age 26. The provision has led to increased coverage and insuredness among young adults. This research letter aimed to quantify the provision’s effects on insuredness, health status, healthcare expenditures, and healthcare use during a 12 month period following post-implementation in 2011. The young adult group, compared to the control group of patients aged 26-34, had higher rates of coverage and increased percentage of reported excellent mental and physical health. The young adult group had also significantly decreased out-of-pocket health expenditure. Interestingly, the number of healthcare visits was not different between the groups, lending credence to the idea that being insured may result in better perception of health and well-being. The study’s limitations lie in its short frame of study and subsequent inability to judge true healthcare use. It does, however, provide evidence in support of the dependent coverage provision of the ACA.

Click to read the study, published today in JAMA

Relevant Reading: Potential Adult Medicaid Beneficiaries Under the Patient Protection and Affordable Care Act Compared With Current Adult Medicaid Beneficiaries

In-Depth [cohort study]: This study consisted of young adults aged 19-25 years, and a control group, consisting of patients aged 26-34 years selected from the 2002-2011 Medical Expenditure Panel Survey. The intervention and control groups totaled 26,453 and 34,052 patients, respectively. The intervention group had a statistically significant 7.2% (CI95%, 4.2%-10.2%) higher probability of having insurance, 6.2% (CI95%, 3.2%-9.3%) higher probability of reporting excellent physical health, and 4.0%(CI95%, 0.6%-7.5%) higher probability of reporting excellent mental health as compared to the control group. Additionally, the intervention group had a 3.7% (CI95%, 0.9%-6.4%) lower rate of percentage of healthcare expenditures paid out-of-pocket coupled with approximately 18%(CI95%, 5%-31%) lower annual out-of-pocket health expenditures. There was no difference in healthcare use between the two groups.

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Image: PD 

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