How Have State Policies to Expand Dependent Coverage Affected the Health Insurance Status of Young Adults?

An evaluation of the effect of state dependent coverage expansion policies on health insurance coverage for young adults found that the laws did not significantly reduce the rate of young adults uninsured.

The authors used data for 19 to 29 year olds from the Current Population Survey's Annual Demographic Supplement for 2000-2008. They conducted difference-in-differences estimates of the policies' impact on young adults' insurance coverage in 19 states.

State dependent coverage expansion policies led to a small increase in dependent coverage: 1.52 percentage points for all young adults and 3.84 percentage points for young adults ages 19 to 25 living with parents. However, adult dependent coverage expansion policies also reduced young adult employee-sponsored insurance (ESI) policyholder coverage; as a result there was no significant improvement in the rate of uninsured young adults.

Federal expansion of young adult dependent coverage under health care reform would likely be more effective than state policies because it would make more employers offer expanded dependent coverage, and entail subsidies and enrollment mandates.

The Robert Wood Johnson Foundation's State Health Access Reform Evaluation (SHARE) funded this study. SHARE supports research on the impact of coverage expansion efforts and guidance on how to effectively implement health reforms. The articles included in this special issue of HSR: Health Services Research represent the first round of SHARE's research.

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