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The Affordable Care Act’s Dependent Care Coverage and Mortality

McClellan, Chandler PhD

doi: 10.1097/MLR.0000000000000711
Original Articles

Background: In September 2010, the Affordable Care Act (ACA) enabled young adults to gain insurance coverage under their parents’ policies.

Objective: Assess the impact of the ACA’s dependent care coverage expansion on young adult mortality rates.

Research Design: Using the Multiple Cause Mortality public use database for 2008–2013, the impact of the ACA is examined with a difference-in-differences analysis of monthly mortality rates using individuals aged 26–30 as a natural control group for young adults aged 19–25.

Results: The average monthly disease-related mortality rate of the 19–25 years old group fell by between 3.1% and 6.1% in the wake of the dependent care coverage expansion. Reduction in mortality was primarily in disease-related causes which are amenable to general medical care such as cardiovascular disease, while mortality due to trauma-related causes, which must be treated regardless of insurance status under preexisting laws, was unaffected.

Conclusion: The reduction in mortality from this single provision of the ACA indicates that larger gains in preventable mortality could be made as health insurance coverage continues to expand under the ACA.

Substance Abuse and Mental Health Services Administration, Rockville, MD

The views expressed herein are those of the author and do not necessarily reflect the views of SAMHSA or DHHS.

The author declares no conflict of interest.

Reprints: Chandler McClellan, PhD, Substance Abuse and Mental Health Services Administration, 5600 Fishers Lane, Rockville, MD 20852. E-mail:

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