Monday, July 28, 2014

Obamacare might benefit college grads more than less-educated young adults

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The Obamacare provision that lets young adults stay on their parents' insurance longer is disproportionately benefiting well-educated twenty-somethings, a new study finds.

The requirement that private insurers cover dependents up to age 26 kicked in shortly after health reform was signed into law. We know that the provision expanded health coverage among young adults. It also reduced delays in getting care.

We know less about other impacts the under-26 rule has had on young adults, like whether young adults identified as being more or less healthy and whether they changed their behavior.

new paper published in the National Bureau of Economic Research sheds light on some of these questions. Consistent with prior research, the authors found that young adults who might benefit from the under-26 rule had an increased probability of having health insurance and decreased medical needs that went unmet due to cost. They were also more likely to report "excellent" health compared to 27- to 29-year olds, who don't qualify as dependents under the new law.

The study actually finds a small but significant decrease in the probability of receiving a flu vaccination; the authors hypothesize that young adults with insurance might be more willing to risk illness than those without.

Certain gains were concentrated among college-educated young adults. When researchers looked at health outcomes among the general young adult population — whether they used preventive care, for example — they didn't see any change. But when they homed in on the college-educated, they saw a significant improvement.

Those who attended college increased the number of well-patient checkups, were more likely to have increases in "very good" or "excellent" self-reported health, and there was a statistically significant decline in obesity. These improvements were not observed for those without a college degree.

"In short, both groups experience large gains in insurance coverage, but obtaining coverage only appears to lead to substantial new investments in health for highly-educated individuals," the authors write.

This may be an indicative of the fact that we are expanding coverage under a system that is more typically used by higher-income and higher-educated Americans. Young adults who are less familiar with the health care system — or have barriers to care besides cost — may not be as able to their health insurance in ways that actually improve health.

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