Young adult coverage used most for pregnancy, substance abuse

April 12, 2013 at 09:49 AM
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Young adults insured through a parent's plan under of a popular provision of the Patient Protection and Affordable Care Act (PPACA) are using that coverage most for depression, substance abuse and pregnancy, according to new research.

The nonpartisan Employee Benefit Research Institute said Thursday that those conditions accounted for 60 percent of hospital claims for young adults enrolled in parents' plans in 2011 as a result of health care reform.  

That's significantly higher than the percentage of treatment for those same conditions in a comparison group of young people who were already enrolled in a parent's plan two years ago. Treatment for mental illness, substance abuse and pregnancy accounted for just one-third of claims among that group.

PPACA requires group health plans that offer dependent coverage to make that coverage available to workers' children until they reach age 26, regardless of student status, marital status or financial support by the employees.

The coverage requirement is among the most popular provisions of the law among consumers.

Many reports have confirmed more young adults had health coverage after the passage of PPACA, but the new EBRI report is the first to identify the major treatments covered.

EBRI examined the impact and experience of reform's young adults' coverage from one large, unnamed national employer on total spending, average spending, out-of-pocket costs, and use of health care services between Jan. 1, 2010, and Dec. 31, 2011.

The study found a cost disparity between the young people who enrolled in a parent's plan after 2011 and those who were receiving that coverage already.

Those enrolled under their parent's plan used an average of $2,866 in 2011, 15 percent higher than the comparison group, which used $2,472 on average.

The implementation of the adult dependent mandate provision of the law does not come without costs, EBRI health research director and report author Paul Fronstin said in a statement Thursday.

"With respect to the experience of one specific large employer examined in the EBRI analysis, following implementation of the mandate, health care spending increased by $2 million, representing 0.2 percent of total health care spending," Fronstin said.

About 3.1 million Americans ages 19 through 25 are now covered by their parents' medical insurance policies due to the health reform law, according to the Department of Health and Human Services.

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