scholarly journals Health insurance coverage and health care utilization: Evidence from the Affordable Care Act’s dependent coverage mandate

2018 ◽  
Vol 21 (2) ◽  
Author(s):  
Barış K. Yörük
Keyword(s):  
Health Care ◽  
Young Adults ◽  
Health Insurance ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Care Utilization ◽  
Insurance Plan ◽  
Health Insurance Plan ◽  
Coverage Rates ◽  
Dependent Coverage

Abstract This paper investigates the impact of the Affordable Care Act’s (ACA’s) dependent coverage mandate on health insurance coverage rates and health care utilization among young adults. Using data from the Medical Panel Expenditure Survey, I exploit the discontinuity in health insurance coverage rates at age 26, the new dependent coverage age cutoff enforced by the ACA. Under alternative regression discontinuity design models, I find that 2.5 to 5.3 percent of young adults lose their health insurance coverage once they turn 26. This effect is mainly driven by those who lose their private health insurance plan coverage and those who lose their health insurance plan coverage, whose main holder resides outside of the household. I also find that the discrete change in health insurance coverage rates at age 26 is associated with up to a 3.6 percentage point decrease in office-based physician and and up to a 2.1 percentage point decrease in dental visits, but does not have a significant impact on the utilization of outpatient or emergency department services. Furthermore, the effects of the ACA’s dependent coverage mandate on health care spending and out-of-pocket costs are insignificant. These results are robust under alternative model specifications.

scholarly journals A Comparison Between Subjective and Objective Methods of Predicting Health Care Expenses to Support Consumers’ Health Insurance Plan Choice

2018 ◽  
Vol 3 (1) ◽  
pp. 238146831878109 ◽  
Author(s):  
Mary C. Politi ◽  
Enbal Shacham ◽  
Abigail R. Barker ◽  
Nerissa George ◽  
Nageen Mir ◽  
...  
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Utilization ◽  
Subjective Health ◽  
Care Utilization ◽  
Insurance Plan ◽  
Health Insurance Plan ◽  
Subjective Health Status ◽  
Reported Health ◽  
Nationally Representative

Objective. Numerous electronic tools help consumers select health insurance plans based on their estimated health care utilization. However, the best way to personalize these tools is unknown. The purpose of this study was to compare two common methods of personalizing health insurance plan displays: 1) quantitative healthcare utilization predictions using nationally representative Medical Expenditure Panel Survey (MEPS) data and 2) subjective-health status predictions. We also explored their relations to self-reported health care utilization. Methods. Secondary data analysis was conducted with responses from 327 adults under age 65 considering health insurance enrollment in the Affordable Care Act (ACA) marketplace. Participants were asked to report their subjective health, health conditions, and demographic information. MEPS data were used to estimate predicted annual expenditures based on age, gender, and reported health conditions. Self-reported health care utilization was obtained for 120 participants at a 1-year follow-up. Results. MEPS-based predictions and subjective-health status were related ( P < 0.0001). However, MEPS-predicted ranges within subjective-health categories were large. Subjective health was a less reliable predictor of expenses among older adults (age × subjective health, P = 0.04). Neither significantly related to subsequent self-reported health care utilization ( P = 0.18, P = 0.92, respectively). Conclusions. Because MEPS data are nationally representative, they may approximate utilization better than subjective health, particularly among older adults. However, approximating health care utilization is difficult, especially among newly insured. Findings have implications for health insurance decision support tools that personalize plan displays based on cost estimates.

scholarly journals Effects of the Affordable Care Act Dependent Coverage Mandate on Health Insurance Coverage for Individuals in Same-Sex Couples

Demography ◽  
2021 ◽  
Author(s):  
Christopher S. Carpenter ◽  
Gilbert Gonzales ◽  
Tara McKay ◽  
Dario Sansone
Keyword(s):  
Young Adults ◽  
Health Insurance ◽  
Affordable Care Act ◽  
Sexual Minorities ◽  
Insurance Coverage ◽  
Large Body ◽  
Health Insurance Coverage ◽  
Same Sex ◽  
Same Sex Couples ◽  
Dependent Coverage

Abstract A large body of research documents that the 2010 dependent coverage mandate of the U.S. Affordable Care Act was responsible for significantly increasing health insurance coverage among young adults. No prior research has examined whether sexual minority young adults also benefitted from the dependent coverage mandate despite previous studies showing lower health insurance coverage among sexual minorities. Our estimates from the American Community Survey, using difference-in-differences and event study models, show that men in same-sex couples aged 21–25 experienced a significantly greater increase in the likelihood of having any health insurance after 2010 than older, 27- to 31-year-old men in same-sex couples. This increase is concentrated among employer-sponsored insurance, and it is robust to permutations of periods and age groups. Effects for women in same-sex couples and men in different-sex couples are smaller than the associated effects for men in same-sex couples. These findings confirm the broad effects of expanded dependent coverage and suggest that eliminating the federal dependent mandate could reduce health insurance coverage among young adult sexual minorities in same-sex couples.

scholarly journals The Effect of the Health Insurance Mandate on Labor Market Activity and Time Allocation: Evidence from the Federal Dependent Coverage Provision

2017 ◽  
Vol 20 (1) ◽  
Author(s):  
Otto Lenhart ◽  
Vinish Shrestha
Keyword(s):  
Young Adults ◽  
Labor Market ◽  
Health Insurance ◽  
Time Allocation ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Unintended Consequences ◽  
Market Activity ◽  
Dependent Coverage ◽  
Labor Market Activity

Abstract The primary goal of the federal dependent coverage mandate was to increase health insurance coverage among young adults, the group with the lowest prevalence of health insurance coverage. To understand the full impacts of the federal dependent coverage mandate, it is important to evaluate how the mandate affects labor market activities and time spent away from work among young adults. Using data from the Consumer Population Survey (CPS) and the American Time Use Survey (ATUS) and implementing a difference-in-differences framework, we find: (1) Young adults substitute employer sponsored insurance for dependent coverage, (2) Affected individuals reduce their work time and switch from full- to part-time employment, and (3) The additional time from reduced labor market activity is reallocated towards more time spent on leisure activities, mainly watching television. The effects of the mandate on labor market activities are stronger in later years. Furthermore, we show that young adults do not increase the time they spend on activities that could enhance their human capital such as education and health, which reemphasizes potential unintended consequences of the mandate. These findings suggest that future work is necessary to fully understand the overall welfare effects of the policy.

Predictors of Consumers’ Health Insurance Knowledge

2017 ◽  
Vol 28 (2) ◽  
pp. 300-312
Author(s):  
Sarah Osmane ◽  
Cathy Faulcon Bowen
Keyword(s):  
Health Insurance ◽  
Financial Literacy ◽  
Insurance Coverage ◽  
Binary Logistic Regression ◽  
Health Insurance Coverage ◽  
Consumer Health ◽  
Insurance Plan ◽  
Health Insurance Plan ◽  
Factors Associated ◽  
Tax Returns

The objectives of this study were to assess consumer knowledge of their health insurance plan and overall financial knowledge and to identify factors associated with consumer health insurance knowledge. A sample of taxpayers who had tax returns completed at a university-based volunteer income tax assistance (VITA) program was surveyed. More than 70% of respondents perceived their health insurance plan knowledge and overall financial literacy to be fair/good on a scale where the top choices were very good, excellent, and exceptional. The results of the binary logistic regression showed that those who were more likely to have high health insurance knowledge were U.S. citizens, not single, and reviewed their health insurance coverage at least once a year.

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