Date of Degree


Document Type


Degree Name





Michael Grossman

Committee Members

Inas R. Kelly

Partha Deb

Subject Categories



Health Economics, Health Policy


This dissertation consists of three essays that examine health care and behavioral issues among young adults in the United States.

Chapter 1 Health Care Issues in the United States

This chapter provides an overview of health care issues in the United States. There are three major problems: high cost of health care, gaps in access, and inadequate health levels. The cost and growth of health care at a rapid rate may due to the complex nature of the U.S. health care system and consumer-driven technology improvement. As health care costs soar, many individuals have been priced out of the health insurance market; consequently leading to poor health status.

Chapter 2 The Effect of the Dependent Coverage Mandate on Risky Health Behavior by Young Adults

Drug overdose is on the rise among young adults. The dependent coverage mandate has allowed young adults to remain covered under their parents’ health insurance policy until age 26 since 2010. This may lead to ex-ante and ex-post moral hazard effects. This study is the first to examine the causal effect of this health care reform on drug prevalence among young adults. Results suggest that unintentional drug poisoning death rate statistically significantly decreases by 1.77 percentage points. I find that the number of unintentional drug poisoning death rate in the state with a high drug-related mortality rate decreases after the dependent coverage mandate. I also find that the federal mandate has a higher degree of an impact than the state regulation.

Chapter 3 Life Decisions Among Young Adults under the Dependent Coverage Mandate

The barrier of high health care costs imposes a serious constraint on young adults. To obtain health insurance coverage influences young adults’ behaviors and their life decisions. The Affordable Care Act enacted the dependent coverage mandate in 2010, whereby young adults could remain covered under their parents’ health insurance policy until age 26. This provided young adults with more flexibility regarding health care and allowed them to make different decisions about their education, career, marriage, and lifestyle after the implementation of dependent coverage. In this paper, I utilize data from American Community Surveys (ACS) and Current Population Survey (CPS) to identify the effect of the dependent coverage mandate on major life-changing decisions among young adults. The results suggest that work, marriage, and pregnancy for young adults are getting delayed, but there are more schooling among young adults after the implementation of the dependent coverage mandate.

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