title: Effects of the Affordable Care Act's young adult insurance expansion on prescription drug insurance coverage, utilization, and expenditures.
abstract: The US Affordable Care Act (ACA) extended the age of eligibility for young adults to remain on their parents' health insurance plans in order to address the disproportionate number of uninsured young adults in the United States. Effective September 23, 2010, the ACA has required all private health insurance plans to cover dependents until the age of 26. However, it is unknown whether the ACA dependent coverage expansion had an impact on prescription drug insurance or the use of prescription drugs.
  
  
  
  To evaluate short-term changes in prescription health insurance coverage, prescription drug insurance coverage, prescription drug use, and prescription drug expenditures following implementation of the ACA young adult insurance expansion using national data from 2009 and 2011.
  
  
  
  Full-year health insurance coverage increased 4.9 percentage points during the study period, which was mainly due to increases in private health insurance among middle- and high-income young adults. In contrast, full-year prescription drug insurance coverage increased 5.5 percentage points and was primarily concentrated among high-income young adults. Although no significant short-term changes in overall prescription drug use were observed, a 30% decrease in out-of-pocket expenditures was seen among young adults.
  
  
  
  While the main goal of the ACA's young adult insurance expansion was to increase health insurance coverage among young adults, it also had the unintended positive effect of increasing coverage for prescription drug insurance. Additionally, young adults experienced substantial decreases in out-of-pocket spending for prescription drugs. It is important for evaluations of health care policies to assess both intended and unintended outcomes to better understand the implications for the broader health system.
authors.affiliation: Social and Administrative Sciences Division, University of Wisconsin-Madison School of Pharmacy, 777 Highland Ave., Madison, WI 53705-2222, USA. Electronic address: kevin.look@wisc.edu.
authors.forename: Kevin A
authors.initials: KA
authors.lastname: Look
authors.affiliation: Social and Administrative Sciences Division, University of Wisconsin-Madison School of Pharmacy, 777 Highland Ave., Madison, WI 53705-2222, USA.
authors.forename: Prachi
authors.initials: P
authors.lastname: Arora
mesh_terms: D000328:Adult; D000367:Age Factors; D005260:Female; D005382:Financing, Personal / Q000191:economics / Q000706:statistics & numerical data; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D019458:Insurance Coverage / Q000191:economics / Q000706:statistics & numerical data*; D007348:Insurance, Health / Q000191:economics / Q000706:statistics & numerical data; D007356:Insurance, Pharmaceutical Services / Q000191:economics / Q000706:statistics & numerical data*; D008297:Male; D058991:Patient Protection and Affordable Care Act; D055553:Prescription Drugs / Q000008:administration & dosage / Q000191:economics; D011795:Surveys and Questionnaires; D014481:United States; D055815:Young Adult
chemical_list: D055553:Prescription Drugs
keywords: Affordable Care Act; Dependent coverage mandate; Health insurance; Health policy; Prescription drug insurance