Performance Improvement 2013-2014. Has the Expansion of Eligibility Increased Dependent Coverage Under Parent Health Insurance Plans?


Researchers analyzed nondiscretionary visits to hospital emergency departments to assess the impact of the expansion of dependent coverage under the Affordable Care Act. A differences-in-differences methodology measured the impact of the expansion on private insurance coverage and uninsurance among individuals aged 19 to 25, as compared those 26 to 31 who were not directly affected by the dependent coverage provisions. The IMS Health proprietary hospital claims data base, reweighted to be nationally representative, was used for the analysis.

After the Affordable Care Act provision took effect, private coverage of nondiscretionary visits to emergency departments by young adults increased by 3.1 percentage points as compared with similar visits in the control group. The percentage of visits by uninsured young adults also fell significantly. The rates of nondiscretionary visits that were covered by Medicaid or other non-private insurers remained relatively steady throughout the study period. The coverage expansion led to an estimated 22 thousand visits to emergency departments by newly insured young adults and $147 million in associated costs that were covered by private insurance plans during a 1-year period (

Report Title: The Early Impact of ACA Reforms: Dependent Coverage Analysis. (Published: “Insurance Coverage of Emergency Care for Young Adults under Health Reform,” New England Journal of Medicine, May 30, 2013,
Agency Sponsor: OASPE, Office of the Assistant Secretary for Planning and Evaluation
Federal Contact: Ken Finegold, 202-401-6644
Performer: Rand Corporation
Record ID: 9756 (June 30, 2012)

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"PerformanceImprovement2014.pdf" (pdf, 671.65Kb)

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