Gary T Pickens

Young Adults, Health Insurance Expansions and Hospital Services Utilization

Under the dependent coverage expansion (DCE) provision of health reform adult children up to 26 years of age whose parents have employer-sponsored or individual health insurance are eligible for insurance under their parents’ health plan. Using a difference-in-differences approach and the 2008–2014 Healthcare Cost and Utilization Project State Emergency Department Databases and State Inpatient Databases we examined the impact of the DCE on hospital services use. In analyses of individuals age <26 years (compared to individuals over 26) we found a 1.5% increase in non-pregnancy related inpatient visits in 2010 through 2013 during the initial DCE period and a 1.6% increase in 2014 when other state expansions went into effect. We found that the impact of the DCE persisted into 2014 when many state insurance expansions occurred, although effects varied for states adopting and not adopting Medicaid expansions.