title: Continued Gains in Health Insurance but Few Signs of Increased Utilization: An Update on the ACA's Dependent Coverage Mandate.
abstract: To evaluate the Affordable Care Act's dependent coverage mandate impact on insurance take-up and health services use through the second full year of implementation.
  
  
  
  Medical Expenditure Panel Survey from 2006 to 2012.
  
  
  
  Difference-in-difference regressions comparing pre-/postpolicy-outcome changes between 19- to 25-year-olds and 27- to 34-year-olds.
  
  
  
  Following significant increases in 2011, insurance take-up among 19- to 25-year-olds leveled off overall in 2012. However, increases in coverage for Black young adults were higher in 2012 compared to 2011. Despite increased coverage, there is little evidence of an overall effect on health services use postmandate. Evidence points to increased doctor visits and emergency department visits among Hispanics in the first year postmandate.
  
  
  
  The Affordable Care Act young adult mandate led to significant gains in insurance take-up, though evidence suggests that the bulk of the gains occurred in the first year after the mandate. Gains for Black young adults appear to have picked up in 2012.
authors.affiliation: University of Iowa College of Public Health, Iowa City, IA, USA dan-shane@uiowa.edu.
authors.forename: Dan M
authors.initials: DM
authors.lastname: Shane
authors.affiliation: University of Iowa College of Public Health, Iowa City, IA, USA.
authors.forename: Padmaja
authors.initials: P
authors.lastname: Ayyagari
authors.affiliation: University of Iowa College of Public Health, Iowa City, IA, USA.
authors.forename: George
authors.initials: G
authors.lastname: Wehby
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000367:Age Factors; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D019458:Insurance Coverage / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D007348:Insurance, Health / Q000331:legislation & jurisprudence* / Q000458:organization & administration / Q000706:statistics & numerical data; D058991:Patient Protection and Affordable Care Act / Q000458:organization & administration / Q000706:statistics & numerical data; D014481:United States; D055815:Young Adult
keywords: Affordable Care Act; dependent coverage mandate; insurance; utilization