Nearly 1 in 3 young adults ages 19 to 25 years lacked health insurance in 2009 - in most cases, they didn't want to incur the cost but one of the goals of the Affordable Care Act, also known as Obamacare, was to get all young people or their parents paying for coverage so that the people who could not get it could afford to be subsidized.

Thus, an early provision of Obamacare mandated that young people had to pay for health insurance - or insurance companies had to let them stay on their parents' policies until age 26. For a recent paper, Meera Kotagal, M.D., M.P.H., of the University of Washington, Seattle, and colleagues examined coverage, access to care and health care use among 19- to 25-year-olds compared with 26- to 34-year-olds after the Obamacare mandate. 

The timing for the paper is good, since September is the month health insurance companies are being forced to pay an $8 billion tax, supposedly because they would be making more money on all those new enrollees.

It hasn't worked out that way, and instead the $8 billion is coming from older healthy people who saw increases in their costs, unless their companies quietly paid the difference. As predicted, health insurance coverage increased among 19- to 25-year-olds, since they could join their parental plan or pay a penalty, but there were no significant changes in health status or the affordability of health care.  

The authors used data from two nationally representative surveys and they found that health coverage for 19- to 25-year-olds increased between 2009 and 2012 from 68.3 percent to 71.7 percent and declined for 26- to 34-year-olds from 77.8 percent to 70.3 percent. The likelihood of having a usual source of care decreased for both groups but the decline was more significant for 26- to 34-year-olds.

However, there was no significant change in health status between the two groups and no significant change between the two groups for who reported receiving a routine checkup in the past year or in their ability to afford prescription medicines, dental care or physician visits.

Individuals with insurance were more likely to have a usual source of care, get a routine checkup and a flu shot, as well as be able to afford physician visits, prescription medications and dental care.

"Understanding the PPACA's full impact on young adults may require a focus on those who consume more health care, such as those with chronic disease," the authors write. 

Source: JAMA