The national implementation of the Affordable Care Act (ACA) in 2014 was connected with yields in health insurance coverage for youth, yet some of those gains have back-pedaled during the last three years, according to a research by the School of Public Health at Drexel University.
Using National Health Interview Survey data, the researchers found that although the overall percentage of uninsured youth dropped by nearly 2% from the periods 2011-2013 to 2014-2015, in 2016-2018, the percentage of youth without insurance decreased 0.3% to a total of 5.1%, or a loss of coverage for 196,000 youth and a total of 3.7 million youth without health coverage.
“Efforts in 2017 and 2018 to reduce advertising budgets, cease payments of cost sharing reductions and other efforts could have undermined the stability of insurance markets and public perceptions of insurance availability,” said lead author Alex Ortega, Ph.D., a professor of health policy and chair of Health Management and Policy. “Insurance declines could be attributed to those actions.”
Notwithstanding this reversal, the researchers found two positive metrics: decreasing racial imbalance in access to care and continued growth in the number of well visits among the U.S youth.
“There are provisions of the ACA aimed at advancing population health through improving access to and quality of health care and implementing cost-saving measures,” said Ortega.
“These include measures focused on making health care more efficient, equitable and effective.”
And despite the overall decrease in coverage from 2014-2015 to 2016-2018, the percentage of those under the age of 18 in the U.S who had a well-child visit in the past year increased.
From 2011 to 2013, 81% of youth had a well-child visit during the former year. From 2016 to 2018, that figure went up to 85% of youth having a well visit during the previous year.
The researchers noted that the ACA requires health insurance firms to cover preventive visits without cost to the patient, so youth can access basic preventive services, including immunizations, regardless of coverage.
“For youth, it appears, that these provisions are increasing the number of well child visits,” Ortega said.
Insurance coverage of Latino youth has been down compared to non-Latino white or black youth since before the ACA enacted in 2010, however, the disparities gap has contracted a bit in the last few years – coverage for Latino youth increased as it dropped for white and black youth from 2016-2018.
The authors presume that information regarding the availability of the ACA’s insurance tax credits and cost sharing reductions may be gradually reaching immigrant populations and limited English proficient persons.