Did the Affordable Care Act's Dependent Coverage Expansion Affect Race/Ethnic Disparities in Health Insurance Coverage?

Health Serv Res. 2018 Apr;53(2):1286-1298. doi: 10.1111/1475-6773.12728. Epub 2017 Jun 8.

Abstract

Objective: To test the impact of the dependent coverage expansion (DCE) on insurance disparities across race/ethnic groups.

Data sources/study setting: Survey data from the National Survey of Drug Use and Health (NSDUH).

Study design: Triple-difference (DDD) models were applied to repeated cross-sectional surveys of the U.S. adult population.

Data collection/extraction methods: Data from 6 years (2008-2013) of the NSDUH were combined.

Principal findings: Following the DCE, the relative odds of insurance increased 1.5 times (95 percent CI 1.1, 1.9) among whites compared to blacks and 1.4 times (95 percent CI 1.1, 1.8) among whites compared to Hispanics.

Conclusions: Health reform efforts, such as the DCE, can have negative effects on race/ethnic disparities, despite positive impacts in the general population.

Keywords: Health insurance coverage; health disparities; young adults.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Ethnicity / statistics & numerical data*
  • Female
  • Healthcare Disparities / statistics & numerical data
  • Humans
  • Insurance Coverage / statistics & numerical data*
  • Insurance, Health / statistics & numerical data*
  • Male
  • Patient Protection and Affordable Care Act / legislation & jurisprudence
  • Patient Protection and Affordable Care Act / statistics & numerical data*
  • Racial Groups / statistics & numerical data*
  • Socioeconomic Factors
  • United States
  • Young Adult