Beginning September 2010, the Affordable Care Act allowed young adults to be covered under their parents' plans up to age 26. After examining health survey results from young adults between the ages of 19 and 34, two Harvard researchers discovered self-reported health among this group had improved in comparison to previous years. Surprisingly, the authors noted, “we did not detect significant changes in health care use; however, only 1 year of post-implementation data was available for our study, which limited statistical power and prevented examination of longer-term changes.” The new study appears in the Journal of the American Medical Association.

Perception Management

Generally, the dependent coverage provision increased insurance coverage and access for young adults. However, little is known about how implementation of the provision has impacted medical spending, health care use, and overall health. Because previous studies have documented rapid improvements in self-reported health among the elderly and low-income adults after they become covered under Medicare and Medicaid, respectively, many health officials have wondered if the same might be true for young adults.

To investigate the potential impact of the dependent coverage provision, the researchers examined the responses and histories of adults between 19 and 34, who had participated in the 2002-2011 Medical Expenditure Panel Survey, an annual survey conducted by the Agency for Healthcare Research and Quality. The researchers identified 26,453 individuals as part of the intervention group (adults 19 to 25 years of age) and 34,052 individuals as part of the control group (adults 26 to 34 years of age). Overall, participants included 47 percent men, while 74 percent of the total identified themselves as white. Group demographics were similar, except fewer young adults in the intervention group were married (nearly 18 percent compared to slightly more than 56 percent in the control group). The researchers analyzed and compared the numbers, while controlling for income, education, sex, employment, and other factors.

What did the researchers discover? For adults between the ages of 19 and 25, insurance coverage increased by 7.2 percent since implementation of the dependent coverage provision. Yet, among this group, they did not record a statistically significant change in health care use. That said, the probability of reporting excellent physical health increased by 6.2 percentage points, while the probability of reporting excellent mental health increased by four percentage points. Seemingly, perceived good health has risen since implementation of the dependent coverage provision. One question remains to be answered: Is the perception of good health a worthy gain?

Source: Chua KP, Sommers BD. Changes in Health and Medical Spending Among Young Adults Under Health Reform. JAMA. 2014.