Health Care Coverage and Access Among Children, Adolescents, and Young Adults, 2010–2016: Implications for Future Health Reforms

• Published in: Journal of adolescent health 2018-06, Vol.62 (6), p.667-673
• Main Authors: Spencer, Donna L., McManus, Margaret, Call, Kathleen Thiede, Turner, Joanna, Harwood, Christopher, White, Patience, Alarcon, Giovann
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescents; Age differences; Child; Children; Children & youth; Delayed; Health care access; Health care policy; Health insurance; Health services accessibility; Insurance coverage; Masking; Medicaid; Older children; Patient Protection & Affordable Care Act 2010-US; Reforms; Teenagers; Young adult; Young adults
• ISSN: 1054-139X; 1879-1972
• DOI: 10.1016/j.jadohealth.2017.12.012

We examine changes to health insurance coverage and access to health care among children, adolescents, and young adults since the implementation of the Affordable Care Act. Using the National Health Interview Survey, bivariate and logistic regression analyses were conducted to compare coverage and access among children, young adolescents, older adolescents, and young adults between 2010 and 2016. We show significant improvements in coverage among children, adolescents, and young adults since 2010. We also find some gains in access during this time, particularly reductions in delayed care due to cost. While we observe few age-group differences in overall trends in coverage and access, our analysis reveals an age-gradient pattern, with incrementally worse coverage and access rates for young adolescents, older adolescents, and young adults. Prior analyses often group adolescents with younger children, masking important distinctions. Future reforms should consider the increased coverage and access risks of adolescents and young adults, recognizing that approximately 40% are low income, over a third live in the South, where many states have not expanded Medicaid, and over 15% have compromised health.