Impacts of the Affordable Care Act Dependent Coverage Mandate on Health-Related Outcomes of Young Adults

The Patient Protection and Affordable Care Act of 2010 aimed to achieve nearly universal coverage in the U.S. The first step in this process – a mandate requiring insurers to allow young adults to remain on their parents’ health insurance plan until their 26^th birthday – took effect in September of 2010. We use data from the Behavioral Risk Factor Surveillance System to examine the effects of this mandate on a wide range of outcomes related to access to health care, utilization of preventive care, health behaviors and self-assessed health. We utilize a difference-in-difference approach that compares changes in these outcomes for the treated age range 19-25 to those for other young adults. A series of placebo tests validates the use of this identification strategy. The mandate increased insurance coverage and the probability of self-reporting excellent health while decreasing medical care foregone because of cost, body mass index, and – surprisingly – the probability of obtaining a flu shot. Across some subgroups we also observe increased probabilities of having a primary care doctor, obtaining any exercise, and attempting to quit smoking, as well as a rise in overall alcohol consumption but a decline in binge drinking. The mandate’s effects are generally most pronounced among those living in states without a prior dependent coverage mandate, whites, older young adults, and college graduates.