Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Jul;105 Suppl 3(Suppl 3):S499-507.
doi: 10.2105/AJPH.2014.302542. Epub 2015 Apr 23.

Health care spending and utilization by race/ethnicity under the Affordable Care Act's dependent coverage expansion

Jie Chen  1 , Arturo Vargas Bustamante, Sarah E Tom
Affiliations

Health care spending and utilization by race/ethnicity under the Affordable Care Act's dependent coverage expansion

Jie Chen et al. Am J Public Health. 2015 Jul.

Abstract

Objectives: We estimated the effect of the ACA expansion of dependents' coverage on health care expenditures and utilization for young adults by race/ethnicity.

Methods: We used difference-in-difference models to estimate the impact of the ACA expansion on health care expenditures, out-of-pocket payments (OOP) as a share of total health care expenditure, and utilization among young adults aged 19 to 26 years by race/ethnicity (White, African American, Latino, and other racial/ethnic groups), with adults aged 27 to 30 years as the control group.

Results: In 2011 and 2012, White and African American young adults aged 19 to 26 years had significantly lower total health care spending compared with the 27 to 30 years cohort. OOP, as a share of health care expenditure, remained the same after the ACA expansion for all race/ethnicity groups. Changes in utilization following the ACA expansion among all racial/ethnic groups for those aged 19 to 26 years were not significant.

Conclusions: Our study showed that the impact of the ACA expansion on health care expenditures differed by race/ethnicity.

PubMed Disclaimer

Figures

FIGURE 1—
FIGURE 1—
Total health care spending and out-of-pocket (OOP) payment as shares of OOP payment to the total health care spending among young adults aged (a) 19–26 years and (b) 27–30 years: United States, 2008–2012. Source. The data source is Medical Expenditure Panel Survey. Statistics are nationally representative (representing approximately 23 million White, 4.2 million African American, 6.2 million Latino, and 2 million other racial/ethnic young adults aged 19–30 years). *P < .05; **P < .01; ***P < .001; Ref = White in the same survey year. †P < .01; Ref = according to race/ethnicity age cohort in 2011–2012.
FIGURE 2—
FIGURE 2—
Health care utilization by race/ethnicity among young adults aged (a) 19–26 years and (b) 27–30 years: United States, 2008–2012. Note. ED = emergency department; PDU = prescription drug use. Source. The data source is Medical Expenditure Panel Survey. Statistics are nationally representative (representing approximately 23 million White, 4.2 million African American, 6.2 million Latino, and 2 million other racial/ethnic young adults aged 19–30 years).
See this image and copyright information in PMC

References

    1. Smith S. CDC: “Young invincibles” have significant health concerns. CNN. 2009. Available at: http://www.cnn.com/2009/HEALTH/02/17/cdc.young.people. Accessed September 1, 2014.
    1. Centers for Medicare & Medicaid Services. Young Adults and the Affordable Care Act: Protecting Young Adults and Eliminating Burdens on Families and Businesses. Washington, DC: Department of Health and Human Services; 2010.
    1. Kaiser Commission on Medicaid and the Uninsured. The uninsured: an interactive tool. 2014. Available at: http://kff.org/interactive/the-uninsured-an-interactive-tool. Accessed September 1, 2014.
    1. Cantor JC, Monheit AC, DeLia D, Lloyd K. Early impact of the Affordable Care Act on health insurance coverage of young adults. Health Serv Res. 2012;47:1773–1790. - PMC - PubMed
    1. Sommers BD, Buchmueller T, Decker SL et al. The Affordable Care Act has led to significant gains in health insurance and access to care for young adults. Health Aff (Millwood) 2013;32(1):165–174. - PubMed

LinkOut - more resources