Were State Dependent Coverage Expansions Effective in Improving the Status of Health Care of Young Adults?

Abstract

To date, 33 states have enacted dependent coverage expansion laws that allow young adults to remain on their parents’ private health plan past 18 years of age, yet very little is known about the effects of these state-level efforts. I examine the impact of these dependent coverage expansions on nine health outcomes including health care access, preventive care use, risky health behavior and self-assessed health of young adults. Using nationally representative Behavioral Risk Factor Surveillance System (BRFSS) data for years 2001-2009 and difference-in-differences models, I utilize the geographic and temporal variations in the adoption of these dependent coverage expansions to estimate their effects on young adults between 19 and 23 years of age. My estimates indicate that the enacted state laws are associated with an increase in the probability of having a yearly checkup by 0.046 but no clear improvement in the likelihood of being insured. In addition, the dependent coverage expansions are also associated with an increase in alcohol consumption by 3.89 drinks per month and a decrease in the probability of self-reporting “excellent” health by 0.045 during their first year of implementation. I also observe a small increase in the probability of participating in any exercise by 0.015. Subsample analyses further reveal that the effects of these laws are similar between both genders, but larger in magnitude among non-whites and 19-21 year-olds when compared to whites and 22-23 year olds respectively.