Association for Public Policy Analysis & Management

We assess whether access to parental health insurance among young adults affects Supplemental Security Income (SSI) application decisions and benefit awards. SSI is the long-term disability program option for those without a strong work history. The prospect of Medicaid coverage has been hypothesized to be a driver of applications to SSI, especially for individuals with disabilities who often lack alternative insurance options. The Affordable Care Act (ACA) of 2010 changed the availability of health insurance coverage for young adults by allowing those under the age of 26 to remain covered through a parent’s health insurance plan. Other studies have found that this policy modestly increased the share of young adults losing health insurance at age 26. This loss of health insurance has been linked to increases in employment and in workers’ compensation claims. We hypothesize that losing health insurance at age 26 may also increase SSI applications among those with a more limited capacity for employment.

We use SSI program data to analyze how applications, awards, and benefit receipt change near the age-26 limit for dependent coverage under the ACA. We estimate impacts using a regression discontinuity (RD) design based on sharp increases in these outcomes among those just over age 26, compared to those just under age 26. Our preliminary findings using application and award data from 2010 to 2016 indicate no distinct changes in SSI applications or awards close to 26.

Ongoing work will use data on the number of beneficiaries by age to address potential downward biases arising from young adults preemptively applying for SSI before age 26 in anticipation of losing parental health insurance. We will address this bias using a refinement the RD analysis framework that can into account more-gradual changes. We also will examine differences across states and time to assess the role of other factors that may have resulted in only a limited impact of losing parental coverage at age 26 on SSI participation. For example, we will consider the role of Medicaid access, including expansions under the ACA, which may have provided alternative routes to health insurance coverage for these individuals after age 26. We also will include descriptive analyses to understand the role of a stronger economy, which may have resulted in more employer-based alternatives to parental health insurance.