The Affordable Care Act Young Adult Mandate and Suicidal Behavior

Med Care Res Rev. 2022 Feb;79(1):17-27. doi: 10.1177/1077558720974144. Epub 2020 Nov 19.

Abstract

This article aimed to determine the association between the Affordable Care Act young adult mandate and suicidal behavior. From 2007 to 2013, we used the Nationwide/National Inpatient Sample and National Poison Data System to examine suicide attempt, and Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research to examine suicide. We aggregated each outcome by quarter/year and conducted a difference-in-differences linear regression to compare young adults aged 19 to 25 years with those 27 to 29 years before and after implementation. There were not statistically significant associations between the mandate and suicide attempt inpatient hospitalizations (unstandardized beta coefficient [b] = -0.72, p = .12, standard error [SE] = 0.42) and percentage of poisoning cases due to suspected suicidal intent (b = 0.23, p = .19, SE = 0.16). There was a statistically significant association when examining suicide prevalence (b = -0.03, p = .01, SE = 0.001). The results suggest that health insurance may buffer against but is unlikely to reverse the increasing suicide rate.

Keywords: Affordable Care Act; difference-in-differences; suicidal behavior; young adult mandate.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Humans
  • Insurance, Health
  • Patient Protection and Affordable Care Act*
  • Prevalence
  • Suicidal Ideation*
  • Suicide, Attempted
  • United States / epidemiology
  • Young Adult