ACA: Small Drop In Emergency Room Visits by Young Adults Interview with:
Asako Moriya Ph.D
School of Public and Environmental Affairs
Indiana University, Bloomington, IN
Center for Financing, Access and Cost Trends
Agency for Healthcare Research and Quality
Rockville, MD

MedicalResearch: What is the background for this study? What are the main findings?

Response: Historically, young adults have had the lowest rate of insurance coverage.  They have also frequently sought non-urgent care in emergency departments (EDs). However, ED care, while appropriate for injuries and other true emergencies, is very expensive and inefficient for non-urgent care. The Affordable Care Act (ACA)’s dependent coverage provision requires health plans that offer dependent coverage to allow young adults to stay on their parents’ private health plans until age 26. This insurance expansion had a potential to improve efficiency by reducing inappropriate ED use.

We used data from the Agency for Healthcare Research and Quality and found that the quarterly ED-visit rate decreased by a small, but statistically significant amount (1.6 per 1,000 population) among adults age 19-25 after the implementation of the ACA’s dependent coverage provision. The decrease was concentrated among women, weekday visits, non-urgent conditions, and conditions that could be treated in other settings. We found no effect among visits due to injury, weekend visits, and urgent conditions.

The findings suggest that the ACA’s dependent coverage provision has increased the efficiency of medical care delivery by reducing non-urgent ED use. Having access to their parents’ health insurance appears to be prompting young adults to use medical care more appropriately.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Response: This study evaluated the ACA’s dependent coverage provision, which only impacts the coverage options for young adults whose parents have private health insurance. The affected young adults most likely are of different socioeconomic and demographic characteristics (for instance, are younger and of higher socioeconomic status) compared to the population that is affected by the overall ACA insurance expansion. Future research will be needed to assess the impact of coverage expansions on the broader range of adults – in terms of both income and age – who will gain coverage under the ACA over the coming decade.


Changes in Emergency Department Use Among Young Adults After the Patient Protection and Affordable Care Act’s Dependent Coverage Provision

Antwi, Yaa Akosa et al.

Annals of Emergency Medicine ; Published Online: March 10, 2015
DOI: Interview with:,  Asako Moriya Ph.D (2015). ACA: Small Drop In Emergency Room Visits by Young Adults 

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Last Updated on March 16, 2015 by Marie Benz MD FAAD