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Health care spending and utilization by race/ethnicity under the Affordable Care Act's dependent coverage expansion
Jie Chen1, Arturo Vargas Bustamante, Sarah E Tom
1Jie Chen is with the Department of Health Services Administration, School of Public Health, University of Maryland, College Park. Arturo Vargas Bustamante is with the Department of Health Policy and Management, Fielding School of Public Health, University of California-Los Angeles. Sarah E. Tom is with the Department of Pharmaceutical Health Services Research, School of Pharmacy, University of Maryland.
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.
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