How Effective are Public Policies to Increase Health Insurance Coverage Among Young Adults?

Abstract

This paper assesses the impact of policies to increase insurance coverage for young adults. The introduction of SCHIP in 1997 enabled low-income teens up to age 19 to gain access to public health insurance. More recent policies enabled young adults between the ages of 19 and (typically) 24 to remain covered under their parents' health insurance. We use the discrete break in coverage at age 19 to evaluate the impact of SCHIP, and quasi-experimental variation to evaluate the impact of “extended parental coverage” laws. Our results suggest that both types of policies were effective at increasing health insurance coverage. (JEL G22, H75, I18, J13)

A Reevaluation of the Effects of State and Federal Dependent Coverage Mandates on Health Insurance Coverage

“…Panel A of Table 1 briefly summarizes other work on the impact of the state mandates on health insurance coverage. Levine et al (2011) and Gamino (2018) argue that the state mandates increased overall coverage, but Monheit et al (2011) suggests they did not. Meanwhile, Depew (2015) and Trudeau and Conway (2018) found it depended on the model they implemented.…”

“…Furthermore, the state mandates did not really require covered individuals to have much since information would naturally flow to members of affected health plans as their dependents did not automatically age out of coverage at 19. A third suggested explanation is difficulty in measurement, as the literature has noted that the results of Levine et al (2011) and Monheit et al (2011) are sensitive to data and specification choices, raising doubts about their validity (Burgdorf, 2014(Burgdorf, , 2015Monheit et al, 2015;Gamino, 2018). Moreover, Depew (2015) and Trudeau and Conway (2018) found estimates were sensitive to the method used to classify who was eligible for state mandates.…”

“…Complete details on the laws and their interpretation can be found in the appendix to Barkowski and McLaughlin (2018). Table 2 presents a comparison of the maximum ages of eligibility (which is one year less than the limiting age) and years of expansion for state mandates according to the data we use, and those used by other authors investigating the effects of the state mandates on health insurance coverage (Levine et al, 2011;Monheit et al, 2011;Depew, 2015;Trudeau and Conway, 2018;Gamino, 2018). We find that there are significant differences between our legal data and those of these other studies.…”

“…In the case of Louisiana, Levine et al (2011) and Monheit et al (2011) code the state as having no mandate, while Depew (2015) and Trudeau and Conway (2018) code it as having one starting in 2009, and Gamino (2018) has it beginning in 1997. We find, however, that it had one dating back to 1974 with a limiting age of 24, requiring a dependent be unmarried, a student, and financially dependent on his or her parents.…”

Access to health insurance and the use of inpatient medical care: Evidence from the Affordable Care Act young adult mandate

“…We estimate negative coefficients for the enactment and implementation phases of the law for both our levels and log specifications with and without patient characteristics for length of stay. Our preferred specification is statistically significant at the [10][11][12][13][14][15][16][17][18][19] percent level for log of length of stay during the implementation period. This result is not robust but suggests a decrease in length of stay for young adults.…”