The health effects of the young adult dependent provision in the patient protection and affordable care act on young adults

Daniel Varughese Thomas, The University of Texas School of Public Health


The adult dependent provision of the PPACA went into effect in September of 2010 and has increased insurance coverage and access to healthcare services for young adults, 19-25 years old. Very few studies have been done assessing the impact of the adult dependent provision on health outcome variables among this population. To determine whether the provision improved health outcomes and costs, we analyzed data from the Medical Expenditure Panel Survey taken over five rounds from 2010 to 2011 for several health outcome and cost variables among insured dependent adults. The population was divided into five groups (gainers, switchers, insured, mcaid and CHIP) indicating different insurance coverage options. Regression analysis then identified statistically significant relationships between the insurance coverage options and the difference in health outcome or cost variable. The results indicated individuals who gained insurance (they were uninsured in the previous period) through the adult dependent provision had changes in several health outcomes. Individuals gaining insurance through the adult dependent provision after being uninsured had a strong association with increased depression, greater incidence of illness or injury requiring immediate care and a reduction in smoking. Individuals insured in both years but switching to dependent sponsored coverage were strongly associated with an improvement in feelings of peacefulness (switchers), a reduction in emergency room visits, improved ability to climb stairs, reduction in being advised to exercise more, and a reduction in smoking. Possible explanations for increased depression and need for care could be due to the delay in care caused by uninsurance in previous years among those gaining insurance. Also, our findings may be a result of moral hazard or a lack of motivation to prevent illness due to protection from having insurance. The improved outcomes among the switchers may be attributable to better coverage through parent employer sponsored plans than those purchased in previous years. We reject the null hypothesis for the beta coefficients for gainers and switchers for the variables indicated above. We believed a priori the high levels of health in this young population would shield them from significant changes in health or cost outcomes, but the results of the study indicate this belief to be false. Our study's strength lies in longitudinal data allowing us to make statements as to the effects of the policy intervention among 19-25 year old adult dependents. Future research should expand the study to include longer time periods to determine long lasting health implications.

Subject Area

Health care management

Recommended Citation

Thomas, Daniel Varughese, "The health effects of the young adult dependent provision in the patient protection and affordable care act on young adults" (2015). Texas Medical Center Dissertations (via ProQuest). AAI1597549.