September 24, 2014– A study released today by the Health Care Cost Institute (HCCI) found that per capita health care spending for young adults (ages 19-25) with employer-sponsored insurance (ESI) grew at a rate nearly double that of other adults (ages 26-64) during 2011 and 2012, the first two years after implementation of the Affordable Care Act (ACA; Section 1001) that allows parents to include their adult children in family health plans.

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New HCCI Study Finds Young Adult Health Care Use Rose After ACA


Emergency room visits and behavioral health hospital admissions grew

Washington, DC – A study released today by the Health Care Cost Institute found that per capita health care spending for young adults (ages 19-25) with employer-sponsored insurance (ESI) grew at a rate nearly double that of other adults (ages 26-64) during 2011 and 2012, the first two years after implementation of the Affordable Care Act (ACA; Section 1001) that allows parents to include their adult children in family health plans. After 2010, young adults’ use of health services grew rapidly – particularly emergency room visits and behavioral health admissions.

The brief, Selected Health Care Trends for Young Adults: 2007-2012, is one of the first to examine health care trends for young adults before and after implementation of Section 1001 of the ACA, which applies to family health policies issued or renewed after September 22, 2010. Prior to the passage of the ACA, many children lost coverage upon turning 19.  Young adult enrollment soared by 3.1 million, or 10.4%, between fall 2010 and the end of 2011, according to the National Health Information Survey, almost all of which was due to increases in private coverage.

In 2011, young adults’ use of health services grew, fueling the 8.3% rise in their health care spending. In contrast, spending on other adults grew by 3.8% in that year.

“This study provides important insights for researchers and policy makers trying to assess the impacts of the ACA on health care use by young adults,” says HCCI Senior Researcher, Amanda Frost. “Clearly, health care use increased and in some cases strikingly.”

Other key findings for young adults:

  • Emergency Room Visits Rose: Spending on ER visits rose 15.6% in 2011. The number of visits per 1,000 young adults increased by 10.4% in 2011, and an additional 3.6% in 2012.  Emergency room use accounted for about 13% of all young adult health spending.
  • Boost in Behavioral Health Spending: Spending on hospital admissions for mental health and substance use jumped by 52.3% in 2011, accelerating a trend that predated the ACA. The increase in spending was largely due to an increase in the number of these admissions. The number of admissions was 146% higher in 2012 than in 2007 for young men and 92% higher for young women. For young men, most of this growth was associated with admissions due to substance use.
  • Spending on Young Men Grew Faster: Throughout the six-year study period, spending grew substantially faster for young adult men than women. Average spending for men rose from $1,341 in 2007 to $1,952 in 2012, while spending for women rose from $2,472 to $3,146.  As a percentage of spending for women, spending for men rose from 54.3% in 2007 to 62.0% in 2012, a pattern of convergence that predated the ACA and may be associated with falling birthrates.
  • Children’s Spending Grew Faster than Young Adults’:  Young adult spending grew by an average of 5.9% per year during 2007-2012.  Spending for other adults averaged 4.5%, while spending for children averaged 6.1%.

The young adult population in this study includes individuals covered by employer-sponsored insurance as the primary beneficiary or as dependents on a spouse’s or parent’s health plan. The researchers compared health care spending and utilization for young adults to national trends for all people younger than age 65 covered by employer-sponsored insurance, using HCCI’s national database of claims for 40 million Americans per year contributed by three national insurers.

The report is available here.

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About the Health Care Cost Institute

The Health Care Cost Institute was launched in 2011 to promote independent, nonpartisan research and analysis on the causes of the rise in U.S. health spending. HCCI is governed by aboard that includes distinguished economists, actuaries and health care experts. For more information, visit www.healthcostinstitute.org or follow us on Twitter @healthcostinst.

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