Table 2.

Exit from Dependent Coverage before and after State and Federal Health Care Reform among Adolescents and Young Adults (Difference‐in‐Differences Results)

Outcome	Age‐Adjusted %/Medians			Multivariate Adjusted Effects (95% CI)
State	Prereform	State Reform	Federal Reform	State (vs. Pre) Reform Effect	Federal (vs. Pre) Reform Effect	Federal (vs. State) Reform Effect
Exit from dependent coverage†				Adjusted Odds Ratios
Massachusetts	29.1%	11.0%	2.9%	0.34**	0.10**	0.28**
				(0.33–0.35)	(0.09–0.10)	(0.27–0.30)
Maine/New Hampshire	27.2%	12.2%	3.5%	0.45**	0.13**	0.30**
				(0.41–0.49)	(0.12–0.15)	(0.26–0.34)
Difference (MA vs. ME/NH)	+1.8%	−1.3%	−0.7%	0.77**	0.73**	0.95
				(0.71–0.84)	(0.65–0.83)	(0.83–1.09)
Age at dependent coverage exit (in years)‡				Adjusted Hazard Ratio
Massachusetts	19.9	22.1	23.3	0.41**	0.13**	0.32**
				(0.40–0.42)	(0.13–0.14)	(0.31–0.33)
Maine/New Hampshire	19.2	19.4	19.9	0.50**	0.18**	0.36**
				(0.47–0.54)	(0.16–0.20)	(0. 32–0.40)
Difference (MA vs. ME/NH)	+0.7	+2.6	+3.3	0.82**	0.73**	0.89
				(0.76–0.89)	(0.65–0.82)	(0.79–1.01)
Regained dependent coverage after prior loss§				Adjusted Odds Ratio
Massachusetts	13.0%	24.4%	50.4%	2.35**	8.69**	3.70**
				(2.21–2.51)	(8.01–9.44)	(3.39–4.03)
Maine/New Hampshire	9.6%	18.9%	30.6%	2.81**	6.58**	2.34**
				(2.31–3.42)	(5.14–8.41)	(1.81–3.01)
Difference (MA vs. ME/NH)	+3.3%	+5.5%	+19.8%	0.84	1.32*	1.58**
				(0.68–1.03)	(1.03–1.70)	(1.21–2.06)

Notes. State reform effect describes the (1) adjusted odds ratio for exit from dependent coverage (AOR <1.0 indicates reduced exit from dependent coverage); (2) adjusted hazard ratio for time to dependent coverage exit (AHR <1.0 indicates lower risk of dependent coverage exit over time); or (3) adjusted odds ratio for regaining dependent coverage (AOR >1.0 indicates greater odds of regained coverage) among young adults with a state‐dependent coverage expansion and state individual mandate compared to a state‐dependent coverage expansion only (with respect to prereform differences).

Federal reform effect describes the (1) AOR for exit from dependent coverage; (2) AHR for time to dependent coverage exit; or (3) AOR for regaining dependent coverage among young adults with a federal‐dependent coverage expansion and state individual mandate compared to a federal‐dependent coverage expansion only (with respect to prereform differences and poststate reform differences).

Multivariate adjusted models additionally controlled for state and reform period main effects, age, gender, chronic condition status, neighborhood poverty, contract type, provider network, coverage source, and deductible.

Data are from Harvard Pilgrim Health Care enrollment files during 2000–2012.

**p ≤ .001; *p ≤ .05.

^†Percent (age‐adjusted) of young adults who exited from dependent insurance coverage in a given period.

^‡Median age at dependent coverage exit in a given period.

^§Percent (age‐adjusted) of young adults who regained dependent coverage after a coverage loss in a given period.