Advocates for Evidence-Based Health Policy Speakers
The ACA Has Worked for Young Adults
Back in 2010, The Affordable Care Act passed with the intention of expanding healthcare coverage to those who were most impacted by an inability to afford insurance or to receive coverage through their employers. Young adults suffer from lack of insurance coverage more than any other age group in the United States with 30% of this population uninsured. Looking back, the ACA has been successful in its goal of expanding coverage to the young adult population. The percentage of young adults insured has increased 6 percentage points; approximately 3 million young adults gained insurance coverage within the first year of the ACA’s implementation. Furthermore, 2.6 percentage points fewer young adults were skipping doctor’s visits due to costs which indicates increased access to care.
However, after analyzing data collected from the Behavioral Risk Factor Surveillance System Annual Surveys, researchers have shown that while the numbers of young adults with insurance has increased, the greatest number of those newly insured have been White. This study demonstrated that, while the rates of those insured and those who have access to care has slightly increased in some minorities (Asians and Hispanics) there has been strikingly little to no impact on non-Hispanic Blacks.
Therefore the ACA resulted in an overall net positive to the nation’s young adults but is further widening existing health care disparities between racial and ethnic groups. This study brings to light the dire need to increase awareness about the ACA in minority communities where it could have an even greater effect. Community organizers could consider social media campaigns and grassroots movements that take place in the heart of minority communities. Proponents for the ACA such as Obamacare-Enroll.org could consider subsidizing community workers who help to sign individuals up. Word still needs to get out for the ACA to penetrate into minority, particularly non-Hispanic Black, communities.
Before leaving office, President Obama said to the students of Miami Dade College that “the net result is that never in American history has the uninsured rate been lower than it is today. Never. And that’s true across the board. It’s dropped among women. It’s dropped among Latinos and African Americans, every other demographic group. It’s worked.” He’s 100% right. It has worked. It just needs to work more for the people who need it the most.
This Policy Prescriptions® review is written by Yajur Maker as part of our collaboration with the Health Policy Journal Club at Baylor College of Medicine where he is a medical student.
Abstract
OBJECTIVES: To examine the impact of the Affordable Care Act’s (ACA’s) 2010 parental insurance coverage extension to young adults aged 19 to 25 years on health insurance coverage and access to care, including racial/ethnic disparities.
METHODS: We pooled data from the Behavioral Risk Factor Surveillance System for the periods 2007 to 2009 and 2011 to 2013 (n?=?402?777). We constructed quasiexperimental difference-in-differences models in which adults aged 26 to 35 years served as a control group. Multivariable statistical models controlled for covariates guided by the Andersen model for health care utilization.
RESULTS: On average, insurance rates among young adults increased 6.12 percentage points after ACA implementation (P?<?.001). All racial/ethnic groups experienced increases in coverage. However, the impact varied by race/ethnicity and was largest for Whites. Young adults had a 2.61 percentage point (P?<?.001) decrease in experiencing barriers to health care because of cost issues after the ACA, with variation by race/ethnicity.
CONCLUSIONS: The ACA’s expansion had a significant positive effect for young adults acquiring health insurance and reducing cost-related barriers to accessing health care. However, racial/ethnic disparities in coverage and access persist. Public Health Implications. Policies not dependent on parental insurance could further increase access and reduce disparities.
PMID: 29470120
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