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Review
. 2018 Apr;75(2):131-152.
doi: 10.1177/1077558716682171. Epub 2017 Jan 5.

Impact of the Affordable Care Act's Dependent Coverage Expansion on the Health Care and Health Status of Young Adults: What Do We Know So Far?

Joshua Breslau  1 , Bradley D Stein  1 , Bing Han  1 , Shoshanna Shelton  1 , Hao Yu  1
Affiliations
Review

Impact of the Affordable Care Act's Dependent Coverage Expansion on the Health Care and Health Status of Young Adults: What Do We Know So Far?

Joshua Breslau et al. Med Care Res Rev. 2018 Apr.

Abstract

The dependent coverage expansion (DCE), a component of the Affordable Care Act, required private health insurance policies that cover dependents to offer coverage for policyholders' children through age 25. This review summarizes peer-reviewed research on the impact of the DCE on the chain of consequences through which it could affect public health. Specifically, we examine the impact of the DCE on insurance coverage, access to care, utilization of care, and health status. All studies find that the DCE increased insurance coverage, but evidence regarding downstream impacts is inconsistent. There is evidence that the DCE reduced high out-of-pocket expenditures and frequent emergency room visits and increased behavioral health treatment. Evidence regarding the impact of the DCE on health is sparse but suggestive of positive impacts on self-rated health and health behavior. Inferences regarding the public health impact of the DCE await studies with greater methodological diversity and longer follow-up periods.

Keywords: Patient Protection and Affordable Care Act; dependent coverage expansion; health insurance; public health impacts; young adults.

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Figures

FIGURE 1
FIGURE 1
POTENTIAL IMPACTS OF THE DCE ON YOUNG ADULTS
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