Impact of the Affordable Care Act's Dependent Coverage Expansion on the Health Care and Health Status of Young Adults

What Do We Know So Far

Published in: Medical Care Research and Review, [Epub January 2017]

Posted on RAND.org on March 14, 2017

by Joshua Breslau, Bradley D. Stein, Bing Han, Shoshana R. Shelton, Hao Yu

Read More

Access further information on this document at Medical Care Research and Review

This article was published outside of RAND. The full text of the article can be found at the link above.

The dependent coverage expansion (DCE), a component of the Affordable Care Act, required private health insurance policies that cover dependents to offer coverage for policyholders' children through age 25. This review summarizes peer-reviewed research on the impact of the DCE on the chain of consequences through which it could affect public health. Specifically, we examine the impact of the DCE on insurance coverage, access to care, utilization of care, and health status. All studies find that the DCE increased insurance coverage, but evidence regarding downstream impacts is inconsistent. There is evidence that the DCE reduced high out-of-pocket expenditures and frequent emergency room visits and increased behavioral health treatment. Evidence regarding the impact of the DCE on health is sparse but suggestive of positive impacts on self-rated health and health behavior. Inferences regarding the public health impact of the DCE await studies with greater methodological diversity and longer follow-up periods.

This report is part of the RAND Corporation external publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.