A new study suggests that, following increases in the provision of health insurance attributable to the Affordable Care Act, the number of young adults self-reporting with excellent physical and mental health has risen significantly.
On September 23, 2010, the Affordable Care Act ensured that health plans that cover children must make that coverage available to them until they reach the age of 26. Prior to this change, insurance companies were able to remove enrolled children at early ages, usually 19.
Children are able to remain on their parents' health plan even if they become married, stop living with their parents, are no longer financially dependent on them or become eligible to enroll in their employer's health plan.
In September 2011, the Centers for Disease Control and Prevention (CDC) reported that during the first 3 months of 2011, the number of young adults aged 19-25 without insurance coverage decreased from 10 million in 2010 to 9.1 million.
In December 2011, results from the National Health Interview Survey (NHIS) suggested that the number of young adults with insurance coverage had risen by 3.1 million since the implementation of the Affordable Care Act.
A Reuters/Ipsos poll released on June 24, 2012, found that 56% of people surveyed were against the Affordable Care Act, compared with 44% who were in favor of it. Despite insurance coverage and access having increased among young adults, the policy has remained largely unpopular with the American public.
What health implications has the policy had?
According to researchers, however, little is currently known about the implications of this policy on overall health, medical spending and health care use. Dr. Kao-Ping Chua, of Harvard University, and Dr. Benjamin D. Sommers, of Harvard School of Public Health, have carried out a study that has aims to address this.
They studied 60,505 adults between 19-34 years of age who were included in the 2002-2011 Medical Exposure Panel Survey, a surgery carried out annually by the Agency for Healthcare Research and Quality. An intervention group of 26,453 young adults aged 19-25 years was compared with a control group of 34,052 adults aged 26-34 years.
Research suggests that extended insurance coverage for young adults has led to improved health.
The year of policy implementation, 2010, was excluded from the study, and 2011 was used as the post-implementation period.
The study, published in JAMA and funded by the Harvard PhD Program in Health Policy, finds that the new insurance provision was associated with a 7.2% rise in coverage among young adults, a 6.2% increase in the probability of self-reporting excellent physical health and a 4% increase in the probability of self-reporting excellent mental health.
The researchers also report that although there were no statistically significant changes in health care use among young adults, the new insurance provision was associated with a 3.7% drop in out-of-pocket expenditures in young adults with any expenditures.
Overall annual out-of-pocket expenditures decreased by around 18% in the young adult group, which was relative to the decrease in the control group.
Insurance coverage 'may improve peace of mind'
Dr. Chua and Dr. Sommers state that previous research documented rapid improvements in self-reported health among low-income and elderly adults gaining Medicaid and Medicare coverage, respectively. In particular, one study found that these gains occurred before any changes in health care use, suggesting that insurance may improve peace of mind and perceptions of health.
This suggestion is supported by the fact that Dr. Chua and Dr. Sommers' research found that there were no statistically significant changes to the amount of health care use among the young adults group.
The researchers acknowledge that their study is limited by the fact that it only had 1 year of data available to analyze following the implementation of the Affordable Care Act. The study is also unable to take into account additional factors that may have affected the outcomes between the intervention and control groups. Further studies will need to address these issues.
The improvements to the health of young adults that this research has found is being connected with the Affordable Care Act. Only further study and time will tell if this will improve the US public's opinion of this policy.
To find out more about the Affordable Care Act, visit our Knowledge Center article about it.
Written by James McIntosh