The Affordable Care Act Improves Healthcare Access And Utilization Among Young Adults With Sickle Cell Disease

Introduction: The Dependent Coverage Provision (DCP) of the 2010 Affordable Care Act aims to improve (1) access to medical care among individuals aged 18-25 nationwide and (2) the efficiency of care by increasing appropriate outpatient care and reducing avoidable inpatient care. Individuals became eligible for coverage under their parents' private insurance in late September 2010. Previous studies have demonstrated improvement in access to care among those eligible for DCP, but no studies have examined the experience of young adults with serious disease requiring chronic medical care such as sickle cell disease (SCD). We hypothesized SCD patients aged 18-25 had increased access to commercial insurance, higher use of outpatient and lower use of inpatient care in the years following DCP implementation compared to patients ineligible for DCP.