Effects of the ACA Dependent Coverage Expansion on Virginia’s Young Adults

The Affordable Care Act (ACA) required that all insurance plans covering dependents extend that coverage to children up to age 26 beginning on or after September 23, 2010. This brief presents new research findings on the impact of the ACA’s dependent coverage mandate on Virginia’s young adults and their use of inpatient hospital care for all non-birth related admissions as well as mental illness and substance abuse admissions. Analysis of hospital discharge data from 2008-2014 shows that the ACA’s dependent coverage mandate increased all non-emergency admissions as well as mental illness and substance abuse admissions. Additional evidence shows that the dependent coverage mandate reduced the share of young adults hospital admissions paid by Medicaid and increased the share of admissions paid by private insurance. The dependent coverage mandate also led to an increase in treatment intensity among hospitalized persons, defined as increased lengths of stay and total charges for non-birth admissions. Overall, this study shows that the ACA’s dependent coverage mandate increases inpatient healthcare utilization. At the same time, a large fraction of patients aged 19-34 who were admitted to hospitals for mental illness treatment in the post-ACA period (20122014) remain uninsured. Policymakers may want to consider other means to expand coverage to those young adults left uninsured in Virginia. Policy Brief ● September 2015 Written by John Snouffer (B.A., 2015; M.P.P., 2016) Snouffer is a 2015 Schroeder Center Brock Institute (SC-BI) Health Policy Research Fellow. Under the SC-BI Fellowship Program, students from William & Mary and medical students from Eastern Virginia Medical School were competitively selected to conduct independent research studies focused on health policy/ health services issues in Virginia. This policy brief is drawn from that research. Jennifer Mellor, Ph.D., Director of the Schroeder Center for Health Policy, served as the William & Mary faculty mentor on this project. Schroeder Center for Health Policy Public Policy Program College of William & Mary