Young adult dependent coverage: were the state reforms effective?
- PMID: 25142384
- PMCID: PMC4256555
- DOI: 10.1111/1475-6773.12220
Young adult dependent coverage: were the state reforms effective?
Abstract
Objective: To examine the robustness of findings regarding state-level adult dependent coverage expansions using detailed outcomes that specify coverage source.
Data sources: This study uses the 2001-2009 files of the Current Population Survey's Annual Social and Economic Supplement, covering calendar years 2000-2008, and considers young adults ages 19 through 29.
Study design: Difference-in-differences methods were used to estimate the effect of state-level dependent coverage expansions on finely detailed categories of coverage, and falsification tests were used to evaluate the models themselves.
Principal findings: Certain published results on state-level parental coverage expansions are flawed, with reported increases driven by changes in spousal coverage. Other published results appear to be in fact driven by parental coverage, but they are not robust to alternative model adjustments.
Conclusions: This study shows evidence that one study's results on "dependent" coverage are in fact driven by changes in rates of spousal coverage. Results from a second study, though not robust to use of a more conventional DD model, would seem to apply most strongly to individuals at ages at which one would typically have lost parental coverage before reform, consistent with a "passive" effect rather than an "active" effect that enrolls previously uninsured youths.
Keywords: Health care reform; dependent coverage; health economics; health insurance regulation; health policy.
© Health Research and Educational Trust.
Comment in
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Drawing Plausible Inferences about the Impact of State Dependent Coverage Expansions.Health Serv Res. 2015 Jun;50(3):631-6. doi: 10.1111/1475-6773.12313. Health Serv Res. 2015. PMID: 25994070 Free PMC article. No abstract available.
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Young adult dependent coverage: were the state reforms effective? A critique and a response.Health Serv Res. 2015 Jun;50(3):637-41. doi: 10.1111/1475-6773.12314. Health Serv Res. 2015. PMID: 25994071 Free PMC article. No abstract available.
References
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- Antwi YA, Moriya AS. Simon K. Effects of Federal Policy to Insure Young Adults: Evidence from the 2010 Affordable Care Act Dependent Coverage Mandate. Cambridge, MA: National Bureau of Economic Research; 2012. NBER Working Paper 18200.
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- Assistant Secretary for Planning and Evaluation [ASPE] Understanding Estimates of the Uninsured: Putting the Differences in Context. Washington, DC: U.S. Department of Health and Human Services, Assistant Secretary for Planning and Evaluation; 2005. ASPE Issue Brief.
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- Bennefield RL. 1996. “A Comparative Analysis of Health Insurance Coverage Estimates: Data from CPS and SIPP. ” Paper presented at the Chicago, IL Joint Statistical Meetings of the American Statistical Association.
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- Bilheimer LT. 1997. “CBO Testimony on Proposals to Expand Health Coverage for Children. ” Paper presented at the Subcommittee on Health. U.S. House of Representatives, Committee on Ways and Means, Washington, DC.
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