Health Care Coverage and Access Among Children, Adolescents, and Young Adults, 2010–2016: Implications for Future Health Reforms

Abstract

Purpose We examine changes to health insurance coverage and access to health care among children, adolescents, and young adults since the implementation of the Affordable Care Act. Methods Using the National Health Interview Survey, bivariate and logistic regression analyses were conducted to compare coverage and access among children, young adolescents, older adolescents, and young adults between 2010 and 2016. Results We show significant improvements in coverage among children, adolescents, and young adults since 2010. We also find some gains in access during this time, particularly reductions in delayed care due to cost. While we observe few age-group differences in overall trends in coverage and access, our analysis reveals an age-gradient pattern, with incrementally worse coverage and access rates for young adolescents, older adolescents, and young adults. Conclusions Prior analyses often group adolescents with younger children, masking important distinctions. Future reforms should consider the increased coverage and access risks of adolescents and young adults, recognizing that approximately 40% are low income, over a third live in the South, where many states have not expanded Medicaid, and over 15% have compromised health.

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“…It is, therefore, important to start teaching children with FH about their condition and its management from 10 to 12 years of age. Better education of young FH patients should improve long-term adherence [34][35][36][37][38], and HEART UK have produced information sheets for different aged children [39].…”

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“…Given their differential needs and health care utilization patterns, assuming that adolescents are accurately represented in larger pediatric trends may result in understating or misunderstanding their current needs and/or barriers to insurance. One recent study highlighted differences in coverage trends among younger children, younger and older adolescents, and young adults between 2010 and 2016, finding that while all groups made insurance gains post‐ACA, each successively older group had lower rates of coverage than their younger peers . Researchers in that study controlled for demographic factors but did not focus on demographic differences beyond age group, region, and insurance type.…”

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