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Did the Affordable Care Act's Dependent Coverage Expansion Affect Race/Ethnic Disparities in Health Insurance Coverage?

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Health Services Research

Published online on


Objective To test the impact of the dependent coverage expansion (DCE) on insurance disparities across race/ethnic groups. Data Sources/Study Setting Survey data from the National Survey of Drug Use and Health (NSDUH). Study Design Triple‐difference (DDD) models were applied to repeated cross‐sectional surveys of the U.S. adult population. Data Collection/Extraction Methods Data from 6 years (2008–2013) of the NSDUH were combined. Principal Findings Following the DCE, the relative odds of insurance increased 1.5 times (95 percent CI 1.1, 1.9) among whites compared to blacks and 1.4 times (95 percent CI 1.1, 1.8) among whites compared to Hispanics. Conclusions Health reform efforts, such as the DCE, can have negative effects on race/ethnic disparities, despite positive impacts in the general population.