Shane Dan M, Ayyagari Padmaja, Wehby George
University of Iowa College of Public Health, Iowa City, IA, USA
University of Iowa College of Public Health, Iowa City, IA, USA.
Med Care Res Rev. 2016 Aug;73(4):478-92. doi: 10.1177/1077558715617066. Epub 2015 Nov 27.
To evaluate the Affordable Care Act's dependent coverage mandate impact on insurance take-up and health services use through the second full year of implementation.
Medical Expenditure Panel Survey from 2006 to 2012.
Difference-in-difference regressions comparing pre-/postpolicy-outcome changes between 19- to 25-year-olds and 27- to 34-year-olds.
Following significant increases in 2011, insurance take-up among 19- to 25-year-olds leveled off overall in 2012. However, increases in coverage for Black young adults were higher in 2012 compared to 2011. Despite increased coverage, there is little evidence of an overall effect on health services use postmandate. Evidence points to increased doctor visits and emergency department visits among Hispanics in the first year postmandate.
The Affordable Care Act young adult mandate led to significant gains in insurance take-up, though evidence suggests that the bulk of the gains occurred in the first year after the mandate. Gains for Black young adults appear to have picked up in 2012.
评估《平价医疗法案》中受抚养人保险覆盖强制规定在实施的第二个完整年度对保险参保率和医疗服务使用的影响。
2006年至2012年的医疗支出小组调查。
采用差异中的差异回归分析，比较19至25岁人群与27至34岁人群在政策实施前后的结果变化。
2011年出现显著增长后，19至25岁人群的保险参保率在2012年总体趋于平稳。然而，与2011年相比，2012年黑人青年成年人的保险覆盖增长更高。尽管保险覆盖有所增加，但几乎没有证据表明强制规定实施后对医疗服务使用有总体影响。有证据表明，在强制规定实施后的第一年，西班牙裔人群看医生和去急诊室就诊的次数有所增加。
《平价医疗法案》中针对青年成年人的强制规定使保险参保率显著提高，不过有证据表明，大部分增长发生在强制规定实施后的第一年。2012年，黑人青年成年人的保险覆盖增长似乎有所加快。
