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Health care spending and utilization by race/ethnicity under the affordable care act's dependent coverage expansion

Author

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  • Chen, J.
  • Bustamante, A.V.
  • Tom, S.E.

Abstract

Objectives. We estimated the effect of the ACA expansion of dependents' coverage on health care expenditures and utilization for young adults by race/ethnicity. Methods. We used difference-in-difference models to estimate the impact of the ACA expansion on health care expenditures, out-of-pocket payments (OOP) as a share of total health care expenditure, and utilization among young adults aged 19 to 26 years by race/ethnicity (White, African American, Latino, and other racial/ethnic groups), with adults aged 27 to 30 years as the control group. Results. In 2011 and 2012, White and African American young adults aged 19 to 26 years had significantly lower total health care spending compared with the 27 to 30 years cohort. OOP, as a share of health care expenditure, remained the same after the ACA expansion for all race/ethnicity groups. Changes in utilization following the ACA expansion among all racial/ethnic groups for those aged 19 to 26 years were not significant. Conclusions. Our study showed that the impact of the ACA expansion on health care expenditures differed by race/ethnicity.

Suggested Citation

  • Chen, J. & Bustamante, A.V. & Tom, S.E., 2015. "Health care spending and utilization by race/ethnicity under the affordable care act's dependent coverage expansion," American Journal of Public Health, American Public Health Association, vol. 105, pages 499-507.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2014.302542_5
    DOI: 10.2105/AJPH.2014.302542
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    Cited by:

    1. Fone, Zachary S. & Friedson, Andrew I. & Lipton, Brandy & Sabia, Joseph J., 2020. "The Dependent Coverage Mandate Took a Bite Out of Crime," IZA Discussion Papers 12968, Institute of Labor Economics (IZA).
    2. Serakos Maria & Wolfe Barbara, 2016. "The ACA: Impacts on Health, Access, and Employment," Forum for Health Economics & Policy, De Gruyter, vol. 19(2), pages 201-259, December.
    3. Alyson Ma & Alison Sanchez & Mindy Ma, 2022. "Racial disparities in health care utilization, the affordable care act and racial concordance preference," International Journal of Health Economics and Management, Springer, vol. 22(1), pages 91-110, March.
    4. Katherine Baird, 2016. "The Financial Burden of Out-of-Pocket Expenses in the US and Canada: How Different is the US?," LIS Working papers 671, LIS Cross-National Data Center in Luxembourg.
    5. Gulzar H. Shah & John P. Sheahan, 2015. "Local Health Departments’ Activities to Address Health Disparities and Inequities: Are We Moving in the Right Direction?," IJERPH, MDPI, vol. 13(1), pages 1-12, December.
    6. Jacqueline Chattopadhyay, 2017. "Is the ACA's Dependent Coverage Provision Generating Positive Feedback Effects Among Young Adults?," Poverty & Public Policy, John Wiley & Sons, vol. 9(1), pages 42-70, March.

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