Article

Expanding Dependent Coverage for Young Adults: Lessons from State Initiatives

Rutgers University.
Journal of Health Politics Policy and Law (Impact Factor: 0.96). 02/2012; 37(1):99-128. DOI: 10.1215/03616878-1496056
Source: PubMed

ABSTRACT The Patient Protection and Affordable Care Act (ACA) requires that adults up to age twenty-six be permitted to enroll as dependents on their parents' health plans. This article examines the experiences of states that enacted dependent expansion laws. Drawing on public information from thirty-one enacting states and case studies of four diverse reform states, it derives lessons that are pertinent to the implementation of this ACA provision. Dependent coverage laws vary across the states, but most impose residency, marital status, and other restrictions. The federal Employee Retirement Income Security Act further limits the reach of state laws. Eligibility for expanded coverage under the ACA is much broader. Rules in some states requiring or allowing separate premiums for adult dependents may also discourage enrollment compared with rules in other states (and the ACA), where these costs must be factored into family premiums. Business opposition in some states led to more restrictive regulations, especially for how premiums are charged, which in turn raised greater implementation challenges. Case study states did not report substantial young adult dependent coverage take-up, but early enrollment experience under ACA appears to be more positive. Long-term questions remain about the implications of this policy for risk pooling and the distribution of premium costs.

0 Followers
 · 
82 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Prior to the Affordable Care Act, the majority of states in the U.S. had already implemented state laws that extended the age that young adults could enroll as dependents on their parent's employer-based health insurance plans. Because of the fundamental link between health insurance and employment in the U.S., such policies may effect the labor supply decisions of young adults. Although the interaction between labor supply and health insurance has been extensively studied for other subpopulations, little is known about the role of health insurance in the labor supply decisions of young adults. I use the variation from the implementation and changes in state policies that expanded dependent health insurance coverage to examine how young adults adjusted their labor supply when they were able to be covered as a dependent on their parent's plan. I find that these state mandates led to a decrease in labor supply on the intensive margin. Copyright © 2014 Elsevier B.V. All rights reserved.
    Journal of Health Economics 12/2014; 39C:123-134. DOI:10.1016/j.jhealeco.2014.11.008 · 2.25 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This paper evaluates one of the first implemented provisions of the Patient Protection and Affordable Care Act (ACA) which permits young adults up to age 26 to enroll as dependents on a parent’s private health plan. The paper also considers how the interaction between prior state laws expanding dependent coverage to young adults and the ACA affected young adult coverage. Using data from the Current Population Survey for calendar years 2004-2010, we apply a difference-in-differences framework to estimate how these provisions affected coverage of eligible young adults compared to slightly older adults. Our findings indicate that controlling for state laws, early implementation of the ACA increased young adult dependent coverage by 5.3 percentage points and resulted in a 3.5 percentage point decline in their uninsured rate. The interaction between state laws and the ACA suggests that the increase in dependent coverage and decline in the uninsured rate may have been greater among young adults who were targeted by both the ACA and state laws.
  • [Show abstract] [Hide abstract]
    ABSTRACT: This study examines the consequences of the Patient Protection and Affordable Care Act (ACA) dependent coverage provision for the health of U.S. young adults aged\–25. Using data from the Current Population Survey—March Supplement for the years 2007–2012 and ordered logistic regression analyses, we examine self-rated health and its association with dependent health insurance coverage for 19- to 25-year-olds and a comparison group of 28- to 34-year-olds before and after implementation of the ACA. Compared to 28- to 34-year-olds, results indicate the post-ACA period (2010–2011) is associated with increased access to dependent health insurance coverage and improved health for young adults aged 19–25 relative to the period before implementation (2008–2009). More than half of the difference in health improvement across age groups can be attributed to changes in dependent coverage. These results are the first to demonstrate a positive health benefit resulting from the implementation of the ACA.
    Sociological Inquiry 03/2014; 84(2). DOI:10.1111/soin.12036 · 0.79 Impact Factor