The ACA's Dependent Coverage Expansion and Out-of-Pocket Spending by Young Adults With Behavioral Health Conditions

Mir M Ali; Jie Chen; Ryan Mutter; Priscilla Novak; Karoline Mortensen

doi:10.1176/appi.ps.201500346

Back

The ACA's Dependent Coverage Expansion and Out-of-Pocket Spending by Young Adults With Behavioral Health Conditions

Journal article

Open access

Peer reviewed

The ACA's Dependent Coverage Expansion and Out-of-Pocket Spending by Young Adults With Behavioral Health Conditions

Mir M Ali, Jie Chen, Ryan Mutter, Priscilla Novak and Karoline Mortensen

Psychiatric services (Washington, D.C.), Vol.67(9), pp.977-982

2016-09-01

DOI: https://doi.org/10.1176/appi.ps.201500346

PMCID: PMC6458594

PMID: 27181735

Abstract

Young Adult

Mental Disorders - therapy

United States

Health Expenditures - statistics & numerical data

Humans

Adult

Patient Protection and Affordable Care Act - economics

Patient Protection and Affordable Care Act - statistics & numerical data

Mental Disorders - economics

Young adults with behavioral health conditions (mental or substance use disorders) often lack access to care. In 2010, the Affordable Care Act (ACA) extended eligibility for dependent coverage under private health insurance, allowing young adults to continue on family plans until age 26. The objective of this study was to analyze out-of-pocket (OOP) spending as a share of total health care expenditures for young adults with behavioral health conditions before and after the implementation of the ACA dependent care provision. The study examined the population of young adults with behavioral health conditions overall and by race and ethnicity. The study analyzed 2008-2009 and 2011-2012 nationally representative data from the Medical Expenditure Panel Survey with zero-or-one inflated beta regression models in a difference-in-differences framework to estimate the impact of the ACA's dependent coverage expansion. OOP spending was examined as a share of total health care expenditures among young adults with behavioral health disorders. The study compared the treatment group of individuals ages 19-25 (unweighted N=1,158) with a group ages 27-29 (unweighted N=668). Young adults ages 19-25 with behavioral health disorders were significantly less likely than the older group to have high levels of OOP spending after the implementation of the ACA's dependent coverage expansion. The reduction was pronounced among young adults from racial-ethnic minority groups. The extension of health insurance coverage to young adults with behavioral health disorders has provided them with additional financial protection, which can be important given the low incomes and high debt burden that characterize the age group.

Files and links (1)

url

https://doi.org/10.1176/appi.ps.201500346View

Published (Version of record) Open

Metrics

11 Record Views

12 Times Cited - Web of Science

See more details

InCites Highlights

These are selected metrics from InCites Benchmarking & Analytics tool, related to this output

Collaboration types: Domestic collaboration
Citation topics: 1 Clinical & Life Sciences; 1.14 Nursing; 1.14.364 Health Insurance
Web Of Science research areas: Health Policy & Services; Psychiatry; Public, Environmental & Occupational Health
ESI research areas: Psychiatry/Psychology

UN Sustainable Development Goals (SDGs)

This output has contributed to the advancement of the following goals:

Source: InCites

Details

Title: The ACA's Dependent Coverage Expansion and Out-of-Pocket Spending by Young Adults With Behavioral Health Conditions
Creators: Mir M Ali - Dr. Ali and Dr. Mutter are with the Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, Maryland (e-mail: mir.ali@samhsa.hhs.gov ). Dr. Chen and Ms. Novak are with the Department of Health Services Administration, School of Public Health, University of Maryland at College Park, College Park, Maryland. Ms. Novak is also an employee of the Agency for Healthcare Research and Quality (AHRQ). Dr. Mortensen is with the Department of Health Sector Management and Policy, School of Business Administration, University of Miami, Coral Gables
Jie Chen - Dr. Ali and Dr. Mutter are with the Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, Maryland (e-mail: mir.ali@samhsa.hhs.gov ). Dr. Chen and Ms. Novak are with the Department of Health Services Administration, School of Public Health, University of Maryland at College Park, College Park, Maryland. Ms. Novak is also an employee of the Agency for Healthcare Research and Quality (AHRQ). Dr. Mortensen is with the Department of Health Sector Management and Policy, School of Business Administration, University of Miami, Coral Gables
Ryan Mutter - Dr. Ali and Dr. Mutter are with the Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, Maryland (e-mail: mir.ali@samhsa.hhs.gov ). Dr. Chen and Ms. Novak are with the Department of Health Services Administration, School of Public Health, University of Maryland at College Park, College Park, Maryland. Ms. Novak is also an employee of the Agency for Healthcare Research and Quality (AHRQ). Dr. Mortensen is with the Department of Health Sector Management and Policy, School of Business Administration, University of Miami, Coral Gables
Priscilla Novak - Dr. Ali and Dr. Mutter are with the Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, Maryland (e-mail: mir.ali@samhsa.hhs.gov ). Dr. Chen and Ms. Novak are with the Department of Health Services Administration, School of Public Health, University of Maryland at College Park, College Park, Maryland. Ms. Novak is also an employee of the Agency for Healthcare Research and Quality (AHRQ). Dr. Mortensen is with the Department of Health Sector Management and Policy, School of Business Administration, University of Miami, Coral Gables
Karoline Mortensen - Dr. Ali and Dr. Mutter are with the Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, Maryland (e-mail: mir.ali@samhsa.hhs.gov ). Dr. Chen and Ms. Novak are with the Department of Health Services Administration, School of Public Health, University of Maryland at College Park, College Park, Maryland. Ms. Novak is also an employee of the Agency for Healthcare Research and Quality (AHRQ). Dr. Mortensen is with the Department of Health Sector Management and Policy, School of Business Administration, University of Miami, Coral Gables
Publication Details: Psychiatric services (Washington, D.C.), Vol.67(9), pp.977-982
Publisher: United States
Grant note: R21 MH106813 / NIMH NIH HHS
Academic Unit: Miami Herbert Business School; MHBS - Health Sector Management and Policy
Language: English
Resource Type: Journal article
PMID: 27181735
PMCID: PMC6458594
Record Identifier: 991031578333602976