Volume 53 | Number 3 | June 2018

Abstract List

Lauren E. Wisk Ph.D., Jonathan A. Finkelstein, Sara L. Toomey M.D., M.Phil., M.P.H., M.Sc., Gregory S. Sawicki M.D., M.P.H., Mark A. Schuster M.D., Ph.D., Alison A. Galbraith M.D., M.P.H.


To determine the effect of state‐level dependent coverage expansion () with and without other state health reforms on exit from dependent coverage for adolescents and young adults ().

Data Sources

Administrative longitudinal data for 131,542 privately insured in Massachusetts ( other reforms) versus Maine and New Hampshire ( other reforms) across three periods: prereform (1/00–12/06), poststate reform (1/07–9/10), and postfederal reform (10/10–12/12).

Study Design

A difference‐in‐differences estimator was used to determine the rate of exit from dependent coverage, age at exit from dependent coverage, and re‐uptake of dependent coverage among in states with comprehensive reforms versus only.

Principal Findings

Implementation of other reforms was significantly associated with a 23 percent reduction in exit from dependent coverage among compared to the reduction observed for alone. Additionally, comprehensive reforms were associated with over two additional years of dependent coverage for the average and a 33 percent increase in the odds of regaining dependent coverage after a prior loss.


Findings suggest that an individual mandate and other reforms may enhance the effect of in preventing loss of coverage among .