Health Care Expenditures among Young Adults with Behavioral Health Disorders under the ACA Dependent Coverage Expansion

Young adults with behavioral health disorders (mental or substance use disorders) often do not have with access to care. In 2010, the Affordable Care Act (ACA) extended eligibility for dependent coverage under private health insurance, allowing young adults to continue on family plans up to age 25. This study estimates health care expenditures, including by race and ethnicity, among young adults with behavioral health disorders before and after the implementation of the dependent care provision of the ACA. Using the 2008-2012 Medical Expenditure Panel Survey (MEPS) data the study utilized a difference-in-differences framework in Zero One Inflated Beta Regression models to estimate the impact of the ACA’s dependent coverage expansion on out-of-pocket payments (OOP) as a share of total health care expenditures among young adults with behavioral health disorders ages 19-25 with ages 27-29 as the comparison group. Results indicate that young adults ages 19-25 with behavioral health disorders were significantly less likely to have high levels of OOP share of health care expenditures after the implementation of the ACA’s dependent coverage expansion compared to their counterparts ages 27-29. In addition, the results showed that the reduction in OOP share was significantly higher among Latinos, African-Americans and young adults of other races.