Did the Affordable Care Act's Dependent Coverage Expansion Affect Race/Ethnic Disparities in Health Insurance Coverage?

Published in: Health Services Research, [Epub June 2017]. doi: 10.1111/1475-6773.12728

Posted on RAND.org on August 01, 2017

by Joshua Breslau, Bing Han, Bradley D. Stein, Rachel M. Burns, Hao Yu

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To test the impact of the dependent coverage expansion (DCE) on insurance disparities across race/ethnic groups.

Data Sources/Study Setting

Survey data from the National Survey of Drug Use and Health (NSDUH).

Study Design

Triple-difference (DDD) models were applied to repeated cross-sectional surveys of the U.S. adult population.

Data Collection/Extraction Methods

Data from 6 years (2008–2013) of the NSDUH were combined.

Principal Findings

Following the DCE, the relative odds of insurance increased 1.5 times (95 percent CI 1.1, 1.9) among whites compared to blacks and 1.4 times (95 percent CI 1.1, 1.8) among whites compared to Hispanics.


Health reform efforts, such as the DCE, can have negative effects on race/ethnic disparities, despite positive impacts in the general population.

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