Dependent Coverage Expansions

Estimating the Impact of Current State Policies

With an estimated 29.3 percent of Americans age 19 to 29 lacking coverage, young adults are more likely to be uninsured than any other age group. Many policy-makers and advocates have ideas about how to insure this group, including enacting a federal statute to expand dependent coverage. Such a statute does not currently exist at the federal level, but new research from the Robert Wood Johnson Foundation-funded State Health Access Reform Evaluation (SHARE), finds that 38 states have some form of mandate to expand dependent coverage to adults in their mid-twenties and beyond. According to the authors from Rutgers University, the experiences of state expansions provide federal policy-makers with valuable information to consider as they develop national policy.

The authors investigate these state-level policies and examine the differences in strategies taken by the states. Their research finds that:

  • Four states require that young adult dependents have no dependents themselves.
  • Most states require state residency for non-students but not for full-time students.
  • Nine states require financial dependence or residency with parents.
  • Six states have continuous or creditable coverage requirements.
  • Most states mandate that all regulated markets and public employee plans abide by expanded adult dependent coverage definitions.
  • 12 states require insurers to average the cost of young adult dependent coverage into group premiums, while eight others required that insurers establish separate premiums for new dependent enrollees.
  • While there has been some take-up of these plans in states, preliminary findings have shown no net effect on coverage rates.