Changes in Insurance Coverage and Access to Care for Young Adults in 2017
Discussant: Sarah Miller
Methods: Data on non-institutionalized U.S. young adults 18-24 years) was obtained from the Behavioral Risk Factor Surveillance System 2011-17 (N=173,848). We employed interrupted time series & difference-in-differences analysis to quantify changes in self-reported insurance coverage, access to a primary care physician, and unmet care due to cost from 2013-2017.
Results: Young adults’ healthcare access continued to improve through 2016; for instance, the percentage of respondents experiencing uninsurance declined by 8.7 points from 2013-2016 (95% CI -9.4 to -8.0). However, these trends began to reverse and from 2016 to 2017, the percentage of young adults who experienced uninsurance increased by 1.4 points (95% CI 0.6 to 2.1), not having a personal doctor increased by 1.1 points (95% CI 0.2 to 2.0), and unmet care due to cost increased by 1.0 points (95% CI 0.3 to 1.7). The 2017 declines in access were concentrated in states which did not expand Medicaid and in households earning above 138% of federal poverty level.
Conclusions: Healthcare access declined for young adults in 2017, following several years of improvements. These changes correspond with recent policy actions which may have weakened the ACA’s reforms.