An evaluation of the affordable care act-dependent coverage provision's impact on young adults' use of health services and outcomes
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Objective: The Affordable Care Act’s Dependent Coverage Provision (DCP) was implemented in 2010 and enabled young adults under the age of 26 years old to remain under their parents’ private health insurance coverage. This study evaluated the impact of the DCP in two ways. The first objective was to examine the impact of the DCP on access to health care in young adults with asthma. The second objective was to investigate the impact of the mandate on health-related outcomes in young adults. Methods: Difference-in-differences (DID) analyses were used to compare changes in outcomes, before and after the implementation of the DCP, between the treatment group (young adults aged 23-25) and the control group (adults aged 27-29). Medical Expenditure Panel Survey data from 2003 to 2013 were used as the data source. Results: In the access to care impact evaluation, the proportion of young adults with asthma who delayed obtaining necessary prescription medications decreased by 8.4 percentage points when compared to the control group. For the health-related outcomes impact evaluation, the probability of young adults having any limitation in work, housework, or school decreased by 1.6 percentage points when compared to the control group. A positive effect was also found onmental health status. The 12-item Short Form Survey (SF-12) mental health component summary score in young adults increased by 0.912 point when compared to the control group. In addition, a reduction of 0.643 kg/m2 in body mass index of young adults was also detected. Conclusions: In regards to access to care, the DCP had a positive effect on obtaining necessary prescription medicine. For health-related outcomes, the findings suggest that the DCP had positive effects on the mental health status, the body mass index and the probability of having any activity limitations. However, insufficient power to detect effects may have limited this study. Future work should consider using alternative data sources such as administrative data.