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VOLUME 50 | NUMBER 3 | JUNE 2015


Young Adult Dependent Coverage: Were the State Reforms Effective? A Critique and a Response

In their 2011 article in Health Services Research, Monheit et al. (2011) use a conventional and seemingly unobjectionable difference-in-difference model to show that state-level reforms designed to extend access to parental insurance were associated with significant increases in the holding of dependent insurance among young adults. In Table 2 of my December 2014 paper in HSR, I was able to closely replicate their finding on “dependent” coverage (Burgdorf 2014). However, I also applied another innovation used by Monheit and colleagues (hereafter, the “Monheit team”) in their later work: the separation of dependent coverage into parental and spousal subcategories. This exercise made clear that their original finding of an increase in “dependent” coverage was secretly hiding an implausible increase in spousal coverage. Obviously spousal coverage did not increase, suggesting a problem with their model—a model that appears to be completely reasonable on its face.

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