Effects of Federal Policy to Insure Young Adults: Evidence from the 2010 Affordable Care Act's Dependent-Coverage Mandate

Antwi, Yaa Akosa; Moriya, Asako S.; Simon, Kosali

doi:10.1257/pol.5.4.1

Cited by 166 publications

(250 citation statements)

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“…This means that our results do not capture effects of that provision, which has been well studied in previous research. [11][12][13][14][15][16] Similarly, our analysis does not estimate coverage gains from early Medicaid expansions that began in 2010 and 2011, which were generally much more limited than the 2014 changes. 17 Our sample excluded adults 65 years of age or older, who are overwhelmingly enrolled in Medicare and thus ineligible for the coverage expansion under the ACA.…”

Section: Discussionmentioning

confidence: 95%

Health Reform and Changes in Health Insurance Coverage in 2014

et al. 2014

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Section: Discussionmentioning

confidence: 95%

Health Reform and Changes in Health Insurance Coverage in 2014

et al. 2014

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“…This provision took effect September 2010. We do not examine this policy here, since it had essentially reached steady-state by 2012 and has already been examined thoroughly elsewhere (Antwi, Moriya, & Simon, 2013). 4 been largely descriptive (Cohen & Martinez, 2014;Long et al, 2014) or limited to a particular aspect of the ACA such as the Medicaid expansion (Black & Cohen, 2015;Kaestner, Garrett, Gangopadhyaya, & Fleming, 2015;Wherry & Miller, 2016).…”

Section: Introductionmentioning

confidence: 99%

Premium subsidies, the mandate, and Medicaid expansion: Coverage effects of the Affordable Care Act

Frean

Gruber

Sommers

2017

Journal of Health Economics

345

144

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Using premium subsidies for private coverage, an individual mandate, and Medicaid expansion, the Affordable Care Act (ACA) has increased insurance coverage. We provide the first comprehensive assessment of these provisions' effects, using the 2012-2015 American Community Survey and a triple-difference estimation strategy that exploits variation by income, geography, and time. Overall, our model explains 60% of the coverage gains in 2014-2015. We find that coverage was moderately responsive to price subsidies, with larger gains in state-based insurance exchanges than the federal exchange. The individual mandate's exemptions and penalties had little impact on coverage rates. The law increased Medicaid among individuals gaining eligibility under the ACA and among previously-eligible populations ("woodwork effect") even in non-expansion states, with no resulting reductions in private insurance. Overall, exchange premium subsidies produced 40% of the coverage gains explained by our ACA policy measures, and Medicaid the other 60%, of which 1/2 occurred among previously-eligible individuals. Americans to obtain insurance (with several exemptions, most notably related to affordability). KeywordsThese principal pieces of the ACA took effect in January 2014. 1 National data from multiple sources strongly support the notion that the ACA has reduced the uninsurance rate substantially beginning in 2014, reaching an historic low by 2015 (Cohen & Martinez, 2014;Smith & Medalia, 2015;Sommers, Gunja, Finegold, & Musco, 2015). This drop has generally been attributed to the ACA, but most analyses of the ACA to date have 1 The earliest coverage expansion enacted under the ACA was the dependent coverage provision, which mandated that private insurers allow parents to cover their children on their insurance until age 26. This provision took effect September 2010. We do not examine this policy here, since it had essentially reached steady-state by 2012 and has already been examined thoroughly elsewhere (Antwi, Moriya, & Simon, 2013). 4 been largely descriptive (Cohen & Martinez, 2014;Long et al., 2014) or limited to a particular aspect of the ACA such as the Medicaid expansion (Black & Cohen, 2015;Kaestner, Garrett, Gangopadhyaya, & Fleming, 2015;Wherry & Miller, 2016). No studies have disentangled the different coverage effects of the ACA's various provisions. Even as the 2016 election results cast uncertainty over the ACA's future, these issues remain critically important to understanding the potential impact of a partial or complete rollback of the law, as well as the potential consequences of future state or federal efforts to expand coverage.In this paper, we provide the first comprehensive model that identifies the causal impact of the ACA's numerous provisions on insurance coverage. In doing so, we also offer an empirical template for future research on this wide-ranging law. We use data from the American Community Survey (ACS) for the two years before and two years after full ACA implementation. We estimate rich mod...

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“…The broader academic literature has also concluded that the provision generated substantial gains in young adult coverage, though estimates vary across studies, with some estimates higher than ASPE's and others lower (Cantor et al 2012;Antwi, Moriya, and Simon 2013;Porterfield and Huang 2016).…”

Section: Expanding Access To Coverage For Young Adultsmentioning

confidence: 99%