A Reevaluation of the Effects of State and Federal Dependent Coverage Mandates on Health Insurance Coverage PDF Download
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Author: Scott Barkowski
Publisher:
ISBN:
Category :
Languages : en
Pages : 0
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Book Description
State governments have been passing laws mandating insurers to allow young adults to stay on their parents' health insurance plans past the age of 19 since the 1970s. These laws were intended to increase coverage, but research has been inconclusive on whether they were successful. We reconsider the issue with an improved approach featuring three key elements: a new, accurate dataset on state mandates; recognition that effects could differ greatly by age due to take up rate differences; and avoidance of endogenous characteristics when identifying mandate eligible young adults. We find the impact of the state mandates was concentrated among the 19 to 22 age group, for which dependent coverage increased sharply by about 6 percentage points. Overall coverage increased by almost 3 percentage points, with the difference explained by crowd out of public insurance. Crowd out of coverage through young adults own jobs was negligible. For those above age 22, we find little evidence of changes in coverage. We incorporate these insights into analysis of the Affordable Care Act (ACA) dependent coverage mandate, showing its effects were focused among those whom were previously ineligible for state mandates, or were eligible but older than 22. We argue the ACA's impact was broader because it had fewer eligibility conditions that implied parental dependence; young adults could be on their parents' insurance but still be relatively independent.
Author: Scott Barkowski
Publisher:
ISBN:
Category :
Languages : en
Pages : 0
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Book Description
State governments have been passing laws mandating insurers to allow young adults to stay on their parents' health insurance plans past the age of 19 since the 1970s. These laws were intended to increase coverage, but research has been inconclusive on whether they were successful. We reconsider the issue with an improved approach featuring three key elements: a new, accurate dataset on state mandates; recognition that effects could differ greatly by age due to take up rate differences; and avoidance of endogenous characteristics when identifying mandate eligible young adults. We find the impact of the state mandates was concentrated among the 19 to 22 age group, for which dependent coverage increased sharply by about 6 percentage points. Overall coverage increased by almost 3 percentage points, with the difference explained by crowd out of public insurance. Crowd out of coverage through young adults own jobs was negligible. For those above age 22, we find little evidence of changes in coverage. We incorporate these insights into analysis of the Affordable Care Act (ACA) dependent coverage mandate, showing its effects were focused among those whom were previously ineligible for state mandates, or were eligible but older than 22. We argue the ACA's impact was broader because it had fewer eligibility conditions that implied parental dependence; young adults could be on their parents' insurance but still be relatively independent.
Author: Aaron M. Gamino
Publisher:
ISBN:
Category :
Languages : en
Pages : 66
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Book Description
I provide new evidence on the effects of state and the ACA dependent mandates by compiling original legal data on the timing and content of initial state adoption of these laws during the 1980s to present. Using this data, I show mandates led to a large and robust increase in young adult insurance coverage and leads to significant differences when replicating prior work. I find supporting evidence that most of the ACAs impact came from self-insured firms adhering to the federal mandate. Mandates led to increased educational attainment, decreased the likelihood of having a child in the past year and affected labor supply decisions of young adults.
Author: Christopher Scott Carpenter
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Category : Homosexuality
Languages : en
Pages : 0
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Book Description
A large body of research documents that the 2010 dependent coverage mandate of the Affordable Care Act was responsible for significantly increasing health insurance coverage among young adults. No prior research has examined whether sexual minority young adults also benefitted from the dependent coverage mandate, despite previous studies showing lower health insurance coverage among sexual minorities and the fact that their higher likelihood of strained relationships with their parents might predict a lower ability to use parental coverage. Our estimates from the American Community Surveys using difference-in-differences and event study models show that men in same-sex couples age 21-25 were significantly more likely to have any health insurance after 2010 compared to the associated change for slightly older 27 to 31-year-old men in same-sex couples. This increase is concentrated among employer-sponsored insurance, and it is robust to permutations of time periods and age groups. Effects for women in same-sex couples and men in different-sex couples are smaller than the associated effects for men in same-sex couples. These findings confirm the broad effects of expanded dependent coverage and suggest that eliminating the federal dependent mandate could reduce health insurance coverage among young adult sexual minorities in same-sex couples.
Author: United States. Congress. House. Committee on Education and the Workforce. Subcommittee on Employer-Employee Relations
Publisher:
ISBN:
Category : Law
Languages : en
Pages : 68
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Author: Scott Barkowski
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Category :
Languages : en
Pages : 0
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We study the effects of state and federal dependent health insurance mandates on marriage rates of young adults, ages 19 to 25. Motivated by low rates of coverage among this age group, state governments began mandating health insurers in the 1970s to allow adult children to stay on their parents' insurance plans. These state level efforts successfully increased insurance coverage rates, but also came with unintended implications for the marriage decisions of young adults. Almost all state mandates explicitly prohibited marriage as a condition of eligibility, thereby directly discouraging marriage. Additionally, by making access to health insurance through parents easier, the mandates made access through spouses' employers relatively less attractive. To the extent that young adults were altering their marriage plans to gain access through potential spouses, they no longer needed to do so under the mandates, thereby implicitly discouraging marriage. When the dependent coverage mandate of the Affordable Care Act (ACA) was enacted, it effectively ended the state-based marriage restrictions, thereby encouraging marriage among young adults previously eligible for state mandates. On the other hand, for those who were not eligible for state mandates, the ACA represented an attractive new path to obtain coverage, thereby discouraging marriage for these young adults, just as the state mandates had implicitly done previously for others. Thus, the separate efforts at the state and federal level to address low coverage rates for young adults ended up interacting and influencing incentives for marriage in opposite directions. We study these interaction effects on marriage empirically using a new dataset we compiled on state-level dependent coverage mandates. Consistent with theoretical arguments, we find that, before the implementation of the ACA, state mandates lowered marriage rates by about 2 percentage points, but this pattern reversed upon the passage of the ACA. We also find that state mandates increased the probability of out-of-wedlock births among state-mandate-eligible women as compared to ineligible ones, but the ACA reversed this trend as well. Our study provides an important example where fundamental understanding of the effects of the ACA dependent coverage mandate can only be had with full consideration of the pre-existing state laws.
Author: Nathan Blascak
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ISBN:
Category :
Languages : en
Pages :
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Author: Baris Yoruk
Publisher:
ISBN:
Category :
Languages : en
Pages : 51
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This paper investigates the impact of the Affordable Care Act's (ACA's) dependent coverage mandate on health insurance coverage rates and health care utilization among young adults. Using data from the Medical Panel Expenditure Survey, I exploit the discontinuity in health insurance coverage rates at age 26, the new dependent coverage age cutoff enforced by the ACA. Under alternative regression discontinuity design models, I find that 2.5% to 5.3% of young adults lose their health insurance coverage once they turn 26. This effect is mainly driven by those who lose their private health insurance plan coverage and those who lose their health insurance plan coverage, whose main holder resides outside of the household. I also find that the discrete change in health insurance coverage rates at age 26 is associated with significant changes in office-based physician and dental visits, but does not have a significant impact on the utilization of outpatient or emergency department services. Furthermore, the effects of the ACA's dependent coverage mandate on health care spending and out-of-pocket costs are insignificant. These results are robust under alternative model specifications.
Author: United States. Congress. House. Committee on Ways and Means. Subcommittee on Health
Publisher:
ISBN:
Category : Business & Economics
Languages : en
Pages : 160
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Author: Gopi Shah Goda
Publisher:
ISBN:
Category : Dependents
Languages : en
Pages : 36
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Book Description
The dependent care mandate is one of the most popular provisions of the 2010 Affordable Care Act (ACA). This provision requires that employer-based insurance plans cover health care expenditures for workers with children 26 years old or younger. While there has been considerable scholarly and policy interest in the effects of this mandate on health insurance coverage among young adults, there has been little scholarly work measuring the costs and incidence of this mandate and who pays the costs of it. In our empirical work, we exploit the fact that some states had dependent care mandates in years prior to the passage of the ACA. Using data from the Survey of Income and Program Participation (SIPP), we find that workers at firms with employer-based coverage -- whether or not they have dependent children -- experience an annual reduction in wages of approximately $1,200. Our results imply that the marginal costs of mandated employer-based coverage expansions are not entirely borne only by the people whose coverage is expanded by the mandate.
Author: Jack W. Derwin
Publisher:
ISBN:
Category : Dependents
Languages : en
Pages : 55
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Book Description
I add to literature investigating the effects of the Affordable Care Act's (ACA) dependent coverage mandate (DCM). I examine how the mandate, which increased health insurance coverage for 19 to 25 year-olds, impacted short-run mortality rates for the affected age group. Unlike previous research, I examine if and how young adult mortality was affected differentially by race. I use data from the CDC's "WONDER" database to conduct difference-in-difference analysis to assess the effects of the policy change on mortality. I find that the DCM had a significant negative impact on mortality rates for the affected age group as a whole, but that African Americans and Asians and Pacific Islanders missed out on the effect. I then briefly investigate what might have driven these racially disparate impacts, but do not produce a conclusive explanation. During that investigation, I also offer a causally-identified estimate of the magnitude of the DCM's effect on health coverage.
