Impact of ACA Insurance Coverage Expansion on Perforated Appendix Rates Among Young Adults

BACKGROUND:The 2010 Dependent Coverage Provision (DCP) of the Affordable Care Act allowed young adults to remain on their parents’ health insurance plans until age 26 years. Although the provision improved coverage and survey-reported access to care, little is known regarding its impact on timely access for acute conditions. This study aims to assess changes in insurance coverage and perforation rates among young adults with acute appendicitis—an established metric for population-level health care access—after the DCP. METHODS:The National Inpatient Sample and difference-in-differences linear regression were used to assess prepolicy/postpolicy changes for policy-eligible young adults (aged 19–25 y) compared with a slightly older, policy-ineligible comparator group (aged 26–34 y). RESULTS:After adjustment for covariates, 19–25 year olds experienced a 3.6-percentage point decline in the uninsured rate after the DCP (baseline 22.5%), compared with 26–34 year olds (P