Aging out of dependent coverage and the effects on the use of inpatient medical care
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Aging out of dependent coverage and the effects on the use of inpatient medical care Tu T. Nguyen1 · Barış K. Yörük2 Received: 1 June 2020 / Accepted: 4 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract We investigate the impact of losing health insurance coverage at age 26 due to aging out of the Affordable Care Act’s dependent coverage on health insurance coverage rates and various indicators of inpatient medical care. We find that the probability of being covered under any type of health insurance plan decreases by 2.5–6.2 percentage points at age 26. However, the effects of this discrete change in health insurance coverage on inpatient medical care and related costs are insignificant. Keywords Affordable Care Act · Health insurance coverage · Dependent coverage · Inpatient visits JEL Classification I11 · I13
Introduction Since September 2010, in the United States, the Affordable Care Act (ACA) requires plans and issuers that offer dependent coverage to make the coverage available until a child reaches the age of 26. The existing literature shows that this policy has significantly increased the number of young adults that are covered by a health insurance plan (Cantor et al. 2012; Sommers and Kronick 2012; Sommers et al. 2013; Akosa Antwi et al. 2013). Recently, several studies investigate the ACA’s dependent coverage mandate on different outcomes such as labor market outcomes, workers’ compensation filing, risky health behaviors, self-assessed health status, routine office based visits, outpatient and inpatient visits, and emergency department visits (Akosa Antwi et al. 2015; Barbaresco et al. 2015; Dahlen 2015; Yörük and Xu 2019; Dillender 2015). In this paper, we contribute to the * Barış K. Yörük [email protected] Tu T. Nguyen [email protected] 1
Department of Economics, University at Albany, SUNY, 1400 Washington Ave., Albany 12222, NY, USA
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Department of Economics, University at Albany, SUNY and CESifo, 1400 Washington Ave., Albany 12222, NY, USA
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T. T. Nguyen, B. K. Yörük
existing literature by investigating the effects of this policy on the use of inpatient medical care and related costs using alternative data and empirical methodology. The existing literature that investigates the effects of the ACA’s dependent care mandate on inpatient medical care uses difference-in-differences (DD) type methods and administrative data (Akosa Antwi et al. 2015). In this paper, we use survey data (household component of the Medical Expenditure Panel Survey-MEPS) instead of administrative data. While survey data may have some shortcomings compared to administrative data, it allows us to estimate the effects of the policy for a broader set of outcomes. To the best of our knowledge, this is also the first paper that investigates the short-run effects of the ACA’s dependent care mandate on the use of inpatient medical care and related costs using the age based cutoff for this policy. We exploit the discrete change in health insurance covera
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