Young Adults’ Access to Insurance Through Parents: Relationship to Receipt of Reproductive Health Services and Chlamydia Testing, 2007–2014

Abstract Purpose Adolescents’ concerns about confidential service receipt have been linked to avoidance of sexual and reproductive healthcare. Healthcare system changes allowing young adults to remain on a parent's health insurance plan up to age 26 may have extended these concerns to young adults. This study examines: (1) The association between the relationship of young women to primary health plan policy holder (parent or self) on receipt of reproductive health services and chlamydia screening. (2)Changes, over time, in the proportion of young women who are parentally- versus self-insured. Methods Cross-sectional analysis of commercially insured young women (18–25) enrolled ≥330days in health plans included in the Truven Health MarketScan commercial claims and encounters database (2007–2014). Results Between 2010 and 2014, the proportion of parentally-insured young women increased significantly across all age groups (AOR = 4.32, CI = 4.29, 4.33). Compared to self-insured young women, parentally-insured young women were less likely to receive a reproductive health service (AOR = .66, CI = .66, .67) and sexually active parentally-insured young women were less likely to receive chlamydia testing (AOR = .75, CI = .75, .76) using their parent's insurance. Conclusions Young women who are insured through a parent are less likely to receive reproductive health services or chlamydia testing using their parent's insurance, which could suggest that concerns about confidential receipt of health services may result in missed care. Various policies, including those related to explanation of benefits sent to a plan policy holder outlining services received, may affect the receipt of confidential healthcare by young adults.