Will health care reform reduce disparities in insurance coverage?: Evidence from the dependent coverage mandate

Dan M Shane; Padmaja Ayyagari

doi:10.1097/MLR.0000000000000134

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Will health care reform reduce disparities in insurance coverage?: Evidence from the dependent coverage mandate

Journal article

Peer reviewed

Will health care reform reduce disparities in insurance coverage?: Evidence from the dependent coverage mandate

Dan M Shane and Padmaja Ayyagari

Medical care, Vol.52(6), pp.528-534

06/2014

DOI: 10.1097/MLR.0000000000000134

PMID: 24783993

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Abstract

We used data from the Medical Expenditure Panel Survey to assess the impact of the Affordable Care Act's dependent coverage mandate on disparities in health insurance coverage rates and evaluated whether non-Hispanic blacks and Hispanics gained coverage at the same rates as non-Hispanic whites. To estimate changes in insurance rates, we employed a difference-in-difference regression approach comparing 7962 young adults aged 19-25 to 9321 adults aged 27-34. Separate regressions were estimated for non-Hispanic blacks, Hispanics, and non-Hispanic whites to understand whether the mandate had differential effects by race/ethnicity. Separate regressions by income level and race/ethnicity were also estimated. Insurance rates increased by 9.3 percentage points among non-Hispanic whites, 7.2 percentage points among Hispanics, and 9.4 percentage points among non-Hispanic blacks. These changes were not significantly different from each other. Among individuals with income of <133% of the Federal Poverty Level, non-Hispanic whites experienced significantly larger gains, whereas at higher-income levels, non-Hispanic blacks experienced significantly larger gains than other racial/ethnic groups. The dependent coverage mandate of the Affordable Care Act increased insurance rates among all racial and ethnic groups but did not change overall disparities. Disparities may have widened among low-income populations which highlights the importance of Medicaid expansions in reducing disparities. Among higher-income populations, disparities between non-Hispanic blacks and non-Hispanic whites were reduced.

Health Expenditures - legislation & jurisprudence

Health Services Accessibility - statistics & numerical data

Healthcare Disparities - statistics & numerical data

Poverty

United States

Health Expenditures - statistics & numerical data

Humans

Healthcare Disparities - ethnology

European Continental Ancestry Group - statistics & numerical data

Hispanic Americans - statistics & numerical data

Male

Health Care Reform - legislation & jurisprudence

Insurance Coverage - legislation & jurisprudence

Medicaid - legislation & jurisprudence

Young Adult

African Americans - statistics & numerical data

Patient Protection and Affordable Care Act - legislation & jurisprudence

Adult

Female

Details

Title: Subtitle: Will health care reform reduce disparities in insurance coverage?: Evidence from the dependent coverage mandate
Creators: Dan M Shane - Department of Health Management and Policy, University of Iowa, Iowa City, IA
Padmaja Ayyagari
Resource Type: Journal article
Publication Details: Medical care, Vol.52(6), pp.528-534
Publisher: United States
DOI: 10.1097/MLR.0000000000000134
PMID: 24783993
ISSN: 0025-7079
eISSN: 1537-1948
Language: English
Date published: 06/2014
Academic Unit: Health Management and Policy; Economics; Public Policy Center (Archive)
Record Identifier: 9984063202102771

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33 Times Cited - Web of Science

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