Medicaid expansion and adolescents' readiness for transition to adult health insurance

In participating states, Medicaid expansion under the Affordable Care Act (ACA) increased availability of health insurance to low-income young adults. We examined the impact of Medicaid expansion on low-income families' knowledge of how adolescents ages 12–17 would obtain insurance coverage upon transitioning to adulthood, compared to families in states that did not expand Medicaid. Based on 2016–2019 data from the National Survey of Children's Health, caregivers in Medicaid-expansion states were more likely to report knowing how their adolescents would have continued coverage, compared to caregivers in states that opted out of Medicaid expansion (odds ratio [OR]: 1.34; 95% confidence interval [CI]: 1.06, 1.70; p = 0.016). The association was strongest for adolescents currently covered by public insurance (OR: 1.50; 95% CI: 1.10, 2.05; p = 0.011), indicating that expansion of public insurance eligibility among adults can help with planning the transition to adult health care for publicly-insured adolescents.

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