The 26‐year threshold in a high‐uninsured state: Evidence from Texas

Abstract The Affordable Care Act's dependent‐coverage mandate reduced uninsurance among young adults, but less is known about the consequences of losing parental insurance at age 26. Using a regression discontinuity design and 2011–2021 Texas Behavioral Risk Factor Surveillance System (BRFSS) data, I find a sharp 5–7 pp (8%) coverage drop at the cutoff, concentrated among unmarried, unemployed, and non‐metropolitan adults. Overall health care use and health outcomes show no statistically significant changes, but women and unemployed adults report declines in good health, and married and employed adults report worse mental health. National BRFSS results show smaller coverage losses (2%–3%), reflecting stronger safety nets outside Texas.

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Publication Details

Journal
Contemporary Economic Policy
Published
2026-02-12
DOI
https://doi.org/10.1111/coep.70024
Primary Topic
Healthcare Policy and Management
Type
article
Field-Weighted Citation Impact
0.00
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article

The 26‐year threshold in a high‐uninsured state: Evidence from Texas

Dajung Jun
Contemporary Economic Policy
Healthcare Policy and Management
article

The 26‐year threshold in a high‐uninsured state: Evidence from Texas

Dajung Jun
article en

Abstract

Abstract The Affordable Care Act's dependent‐coverage mandate reduced uninsurance among young adults, but less is known about the consequences of losing parental insurance at age 26. Using a regression discontinuity design and 2011–2021 Texas Behavioral Risk Factor Surveillance System (BRFSS) data, I find a sharp 5–7 pp (8%) coverage drop at the cutoff, concentrated among unmarried, unemployed, and non‐metropolitan adults. Overall health care use and health outcomes show no statistically significant changes, but women and unemployed adults report declines in good health, and married and employed adults report worse mental health. National BRFSS results show smaller coverage losses (2%–3%), reflecting stronger safety nets outside Texas.

Contemporary Economic Policy
The University of Texas at San Antonio Health Science Center (US)
Openalex Percentile: Top 63%
Healthcare Policy and Management
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