title: ACA dependent coverage provision reduced high out-of-pocket health care spending for young adults.
abstract: Since September 2010 the Affordable Care Act (ACA) has required that insurers allow children to remain as dependents on their parents' private insurance plans until age twenty-six. Studies have shown that this provision increased coverage rates among young adults. In this article we analyze whether the provision also protected young adults from large and uncertain out-of-pocket expenses. We found that the policy was associated with a statistically significant reduction in the share of young adults facing annual out-of-pocket expenditures greater than $1,500 (decreasing from 4.2 percent to 2.9 percent), compared to an increase in the proportion of their slightly older peers facing such expenditures (increasing from 4.4 percent to 5.4 percent), a net difference of -2.4 percentage points, or 57 percent. We conclude that the dependent coverage provision in the ACA provides financial protection for young adults at a time when they often face high debt burden but low wages.
authors.affiliation: Susan H. Busch (susan.busch@yale.edu) is an associate professor in the Department of Health Policy and Management at the Yale School of Public Health, in New Haven, Connecticut.
authors.forename: Susan H
authors.initials: SH
authors.lastname: Busch
authors.affiliation: Ezra Golberstein is an assistant professor in the Division of Health Policy and Management at the University of Minnesota School of Public Health, in Minneapolis.
authors.forename: Ezra
authors.initials: E
authors.lastname: Golberstein
authors.affiliation: Ellen Meara is an associate professor at the Dartmouth Institute for Health Policy and Clinical Practice in the Geisel School of Medicine at Dartmouth, in Hanover, New Hampshire, and a faculty research fellow with the National Bureau of Economic Research in Cambridge, Massachusetts.
authors.forename: Ellen
authors.initials: E
authors.lastname: Meara
mesh_terms: D000328:Adult; D005102:Health Expenditures; D006801:Humans; D019458:Insurance Coverage / Q000331:legislation & jurisprudence*; D007348:Insurance, Health / Q000191:economics*; D010290:Parents; D058991:Patient Protection and Affordable Care Act; D014481:United States; D055815:Young Adult
keywords: Cost of Health Care; Insurance Coverage < Insurance