The Patient Protection and Affordable Care Act (PPACA) has significantly cut the out-of-pocket costs for behavioral health care, and the biggest beneficiaries of reduced costs are young adults from racial and ethnic minorities.

A study from the University of Miami School of Business Administration, published in the journal Psychiatric Services, found that the dependent coverage provision of PPACA has cut the number of uninsured young people by at least three million, since it allows young adults to stay covered by their family’s insurance till age 26.

Since behavioral health conditions can show up for the first time between the ages of 19 to 25, and because this age group has a higher rate of serious mental illness than other adults, improving affordable access to care could result in a significant improvement to the mental health of this group of Americans, including lowering their share of medical debt.

Researchers analyzed data from the Medical Expenditure Panel Survey from 2008–2009 (prior to implementation of PPACA) and 2011–2012 (after PPACA took effect) to estimate how much of an impact dependent coverage expansion had on the population. They also looked at out-of-pocket spending as a share of total health care spending among young adults with behavioral health needs. The results were significant.

Young adults who benefited from dependent coverage on behavioral health were approximately 45 percent less likely to encounter catastrophic health expenses (i.e., 75 percent out-of-pocket share of health care costs) under the PPACA’s dependent coverage expansion.

“Improved access to mental health care for people in this age group is critical given that they often have lower incomes, higher debt burden, and behavioral health issues often emerge at this age,” Karoline Mortensen, associate professor of health sector management and policy at the University of Miami School of Business Administration, said in a statement.

Mortensen, who conducted the research with University of Maryland School of Public Health researchers, added, “We also found young Latinos, African Americans and other racial and ethnic minorities saw the greatest reduction in out-of-pocket medical expenses related to behavioral health. Those in this group of Americans often experience higher unemployment rates and lower salaries and, therefore, are less likely to seek behavioral health services.”

Instant Insights /

PPACA reduces mental health care costs for young adults

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