Expanded Young Adult Dependent Coverage Under the Affordable Care Act and Its Implications for Risk Pooling

One of the earliest Affordable Care Act (ACA) coverage provisions implemented after the passage of the law was the expansion of young adult dependent coverage, which was designed to address the disproportionately high rate of uninsurance among young adults.

This brief highlights research on the health and socio-economic profile of young adults who obtained dependent coverage in the first full year of implementation of the ACA dependent coverage expansion and the resulting implications for risk pooling.

Key Findings

  • The ACA’s dependent coverage expansion achieved early success.

    Since implementation in the last quarter of 2010 and through 2011, the overall prevalence of uninsurance among young adults decreased.

  • Analyses did not yield adverse selection implications for Medicaid or subsidized private plans in the health insurance marketplaces.

    There is no evidence that overall young adult coverage increased differentially by self-reported health status, income or gender in such a way to meaningfully alter the risk profile of the remaining uninsured young adults.