AHCA could jeopardize health coverage for young adults, study suggests
Without an individual mandate, young adults were more likely to lose health insurance.
As the U.S. Senate takes up the proposed American Health Care Act, a new study provides evidence that eliminating the individual mandate could jeopardize healthcare coverage for young adults.
Analysis of insurance data found that without an individual mandate, young adults were more likely to lose health insurance -- even with the Obamacare provision allowing people under age 26 to be covered under their parents' health plan.
The study, led by Lauren Wisk, PhD, of the Division of Adolescent and Young Adult Medicine at Boston Children's Hospital, appears in the upcoming issue of the journal Health Services Research.
Wisk and her co-authors analyzed data from 131,542 adolescents and young adults in Massachusetts, Maine and New Hampshire whose family was covered by Harvard Pilgrim Health Care between January 2000 and December 2012. Massachusetts introduced an individual mandate in 2007, while Maine and New Hampshire did not. This allowed a natural comparison before the individual mandate went into effect nationally in 2014.
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The authors found that having an individual mandate boosted the effect of the dependent coverage expansion, which took effect in these three states and others in 2007, and nationally in 2010.
With both the individual mandate and the dependent coverage expansion in effect, young adults in Massachusetts were 23 percent more likely to keep their dependent coverage than their counterparts in Maine or New Hampshire. They also kept their dependent coverage for longer periods of time, were 33 percent more likely to regain dependent coverage after going off their parents' plan.
The current AHCA retains the dependent coverage provision, and it would seem to protect young adults. However, various other provisions in the bill could undercut that provision, the study found.
Without an individual mandate, more young adults and their families may choose to go without dependent coverage even when it's needed, the authors wrote. The AHCA would limit the tax credits available to families and provide significantly less income-based assistance, which may make it too expensive for some families to keep a young adult child covered as a dependent.
[Also: Numbers of uninsured would increase by 23M under AHCA, CBO says]
Moreover, while the current version of the AHCA retains coverage of pre-existing conditions, young adults who lose or drop their insurance could be charged 30 percent higher premiums for one year after resuming coverage. Such lapses in insurance are common for young adults, who may leave dependent coverage as they enter college or get entry-level jobs, but then find their parents' policies offer better coverage.
"At Boston Children's we see many adolescents and young adults with chronic conditions who could lose access to their doctors under the ACHA when they change plans, or find that the AHCA changes make it too expensive to keep seeing their doctors," said Wisk in a statement. "Our study suggests that the individual mandate encourages young adults to have better, continuous access to the care they need. The AHCA could change that."
Twitter: @JELagasse
