Public Release: 

Access to care among young adults increases after health insurance expansion

The JAMA Network Journals

Bottom Line: Health insurance coverage increased, as expected, among 19- to 25-year-olds after the Patient Protection and Affordable Care Act (PPACA) allowed them to remain on their parents' insurance longer but there were no significant changes in perceived health status or the affordability of health care.

Author: Meera Kotagal, M.D., M.P.H., of the University of Washington, Seattle, and colleagues.

Background: Nearly 1 in 3 young adults ages 19 to 25 years lacked health insurance in 2009. An early provision of the PPACA implemented in 2010 mandated that insurance companies allow young adults to remain beneficiaries on their parents' insurance until they are 26. The authors examined coverage, access to care and health care use among 19- to 25-year-olds compared with 26- to 34-year-olds after the PPACA provision was implemented.

How the Study Was Conducted: The authors used data from two nationally representative surveys.

Results: Health coverage for 19- to 25-year-olds increased between 2009 and 2012 from 68.3 percent to 71.7 percent and declined for 26- to 34-year-olds from 77.8 percent to 70.3 percent. The likelihood of having a usual source of care decreased for both groups but the decline was more significant for 26- to 34-year-olds. However, there was no significant change in health status between the two groups and no significant change between the two groups for who reported receiving a routine checkup in the past year or in their ability to afford prescription medicines, dental care or physician visits. Individuals with insurance were more likely to have a usual source of care, get a routine checkup and a flu shot, as well as be able to afford physician visits, prescription medications and dental care.

Discussion: "Understanding the PPACA's full impact on young adults may require a focus on those who consume more health care, such as those with chronic disease."


(JAMA Pediatr. Published online September 8, 2014. doi:10.1001/jamapediatrics.2014.1208. Available pre-embargo to the media at

Editor's Note: This study was supported by a grant from the University of Washington Department of Surgery and the National Institute of Diabetes and Digestive and Kidney Diseases. Please see article for additional information, including other authors, author contributions and affiliations, etc.

Media Advisory: To contact author Meera Kotagal, M.D., M.P.H., call Leila Gray at 206-685-0381 or email

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