Gaining coverage under parents’ plans makes a difference in care of young adults

Young adults with health insurance coverage are more likely to have regular medical visits and are less likely to go without care, delay care or end up in the emergency department, according to survey results released by the Centers for Disease Control and Prevention.

Researchers were interested in whether coverage made a difference in young adults’ access to care after a provision in the health system reform bill made them eligible to remain covered under their parents’ health plans. The new rule, which went into effect Sept. 23, 2010, allows parents to keep adult children enrolled in their health plan until the child turns 26.

Adults 19-26 with private or public coverage were significantly more likely than uninsured young adults to say they have a place they usually go to get health care when they are sick. The insured also were much more likely to have seen a doctor recently — 77.9% of privately insured and 83.3% of those in public plans had seen a doctor in the last year, compared with 48.1% of the uninsured (link).

In the same age group, 25.1% of the uninsured had visited an emergency department in the preceding year, compared with 18.3% of the privately insured and 35.9% enrolled in public plans. Uninsured young adults also were far more likely to delay or forgo needed care due to cost: 28% delayed or skipped care in the last year, compared with 7.6% of those privately insured and 10.1% in public plans.

Women were more likely to see a doctor than men, and whites were more likely to go to a physician than African-Americans or Hispanics.

The CDC said it released the data to get an early line on the effectiveness of health reform for the young adult population. However, it did not declare whether it considered the Patient Protection and Affordable Care Act a success in insuring those ages 19-26.

Gallup polling shows the number of uninsured people ages 19-26 at around 24.5%, as of the first quarter of 2012, similar to the rate in the same period of 2011. Gallup noted that most of the decline in the uninsured rate happened immediately after the young adult provision of the health reform law went into effect (link).

The U.S. Dept. of Health and Human Services announced in December 2011 that the coverage rate for 19- to 26-year-olds rose from 64% in September 2010 to 73% in June 2011, translating to an estimated 2.5 million additional insured young adults. The government credited the new rules for expanding coverage, because the rise in insurance coverage was largely due to an increase in the percentage of young adults who are privately insured, from 49% to 58%, rather than a rise in the number covered under Medicaid or other public plans.

The limit to the expansion may lie partly in lack of awareness. A survey by eHealthInsurance found that only about half of college students and recent college graduates were aware of the rule that allows them to be insured under a parent’s health plan until age 26. According to a survey of 526 college students and recent graduates between 18 and 30 conducted for the company in April, only 43% of full-time students and 57% of recent graduates (equal to 49% of the combined students and graduates) were aware of the rule.

But knowledge of the new law won’t always help an eligible young adult gain access, because not all parents are willing or able to extend their coverage.

A parallel survey of 550 parents of college-age children also conducted in April for eHealthInsurance found that 42% of those with children younger than 26 did not plan to extend their coverage to their children.

Asked to choose from a list of things parents should do to help children who are recent graduates, only 30% said they thought parents should help pay for health insurance. But the reasons for a parents to answer “no” might not be simply a desire to have their adult children fend for themselves, said Carrie McLean, consumer specialist for eHealthInsurance.

Many employers anticipating increased costs due to the change in the coverage rule raised the price for employees to cover dependents, she said. She said parents faced with a hefty premium might opt to pay for a child’s coverage under an individual plan.

It also may be that the parents’ health plan doesn’t offer a network of physicians and hospitals where the adult child lives. And, finally, for many parents, there is no employer-sponsored health plan to extend to their adult children.