A new report released by leading research organization Urban Institute has revealed how ACA Medicaid expansion led to a drastic fall in uninsurance rates among adults aged 19-25 between 2011 and 2018. The report says uninsurance among young adults in the mentioned period came down from 30.2 percent to 16 percent, a fall of 14.2 percentage. Also, the share of young adults covered by Medicaid increased 4.3 percentage points, from 11.1 percent to 15.4 percent.
- The report says the average decline in uninsurance rates was greater in Medicaid expansion states. Uninsurance rates among young adults declined by 16.4 percentage points, from 27.7 percent in 2011 to 11.3 percent in 2018, in states that expanded Medicaid. It dropped by 11.9 percentages points, from 32.8 percent in 2011 to 20.9 percent in 2018, in non-expansion states.
- Medicaid coverage among adults aged 19 to 25 in expansion states increased by 8.6 percentage points from 12.2 percent in 2011 to 20.8 percent in 2018, with the greatest gains concentrated between 2013 and 2015. In none-xpansion states, Medicaid coverage remained unchanged at 9.8 percent over the same period.
- “When stratifying by race and ethnicity, we find a large reduction in uninsurance for Hispanic young adults (6.0 percentage points), who had the highest pre-ACA uninsurance rate of the racial/ethnic groups in our analysis. Uninsurance declined by 3.7 and 2.5 percentage points for non-Hispanic Black and non-Hispanic white young adults, respectively,” says the report titled ‘Impacts of the ACA’s Medicaid Expansion on Health Insurance Coverage and Health Care Access among Young Adults’.
- Among young adults in households with incomes below 200 percent of FPL, Medicaid expansion is associated with a 7.5 percentage-point decline in uninsurance, a 20.1 percent decline relative to the average uninsurance rate in expansion states between 2011 and 2012. Young adults in higher-income households experienced a smaller and insignificant decline in uninsurance of 1.9 percentage points.
- The study found that between 2011–13 and 2015–18, the likelihood of receiving a routine checkup increased by 5.3 percentage points in expansion states; the likelihood of delaying needed care because of cost declined by 5.6 and 4.7 percentage points in expansion and non-expansion states, respectively; the likelihood of having a personal doctor increased by 2.1 percentage points, in expansion states but did not change in non-expansion states; and the likelihood of receiving a flu shot or nasal spray in the past year increased similarly in expansion and non-expansion states.