NCHS Data Brief ■ No. 137 ■ December 2013

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

Trends in Insurance Coverage and Source of

Private Coverage Among Young Adults Aged 19–25:

United States, 2008–2012

Whitney K. Kirzinger, M.P.H.; Robin A. Cohen, Ph.D.; and Renee M. Gindi, Ph.D.

Young adults often experience instability with regard to work, school, 

residential status, and financial independence. This could contribute to a lack 

of or gaps in insurance coverage (1,2). In September 2010, the Affordable 

Care Act (ACA) extended dependent health coverage to young adults up to 

age 26. This provision was expected to lead to increases in private coverage 

for young adults aged 19–25 when they became eligible for coverage through 

their parents’ employment (3,4). This report provides estimates describing the 

previous insurance status and sources of coverage among privately insured 

young adults aged 19–25, using data from the 2008–2012 National Health 

Interview Survey (NHIS). Comparisons are made with adults aged 26–34, the 

most similar age group that was not affected by the ACA provision.

Keywords: Affordable Care Act (ACA) • private health insurance • 

policyholder

The percentage of those aged 19–25 with private health 

insurance coverage has increased, and the percentage 

uninsured has decreased.

Key findings

Data from the National 

Health Interview Survey, 

2008–2012

• The percentage of young 

adults with private health 

insurance coverage increased 

from the last 6 months of 2010 

through the last 6 months of 

2012 (52.0% to 57.9%).

• Except for an increase in 

the first 6 months of 2011, the 

percentage of privately insured 

young adults who had a gap 

in coverage during the past 12 

months decreased from the first 

6 months of 2008 through the 

last 6 months of 2012 (10.5% 

to 7.8%).

• The percentage of privately 

insured young adults with 

coverage in their own name 

decreased from 40.8% in the 

last 6 months of 2010 to 27.2% 

in the last 6 months of 2012.

• The percentage of privately 

insured young adults with 

employer-sponsored health 

insurance increased from the 

last 6 months of 2010 to the last 

6 months of 2012 (85.6% to 

92.5%).

Figure 1. Percentages of young adults aged 19–25, by health insurance coverage status at time of 

interview and at 6-month intervals: United States, 2008–2012

1

Significant linear trend from January–June 2008 through July–December 2010 (p < 0.05). 2

Significant linear trend from July–December 2010 through July–December 2012 (p < 0.05).

NOTE: Data are based on household interviews of a sample of the civilian noninstitutionalized population.

SOURCE: CDC/NCHS, National Health Interview Survey, 2008–2012.

Expansion of private health insurance 

coverage for dependents aged 19–25

0

10

20

30

40

50

60

70

Public coverage1

Private coverage1,2

Uninsured1,2

Percent

Jul–

Dec

2012

Jan–

Jun

2012

Jul–

Dec

2011

Jan–

Jun

2011

Jul–

Dec

2010

Jan–

Jun

2010

Jul–

Dec

2009

Jan–

Jun

2009

Jul–

Dec

2008

Jan–

Jun

2008
NCHS Data Brief ■ No. 137 ■ December 2013

■  2  ■

• Among young adults aged 19–25, the percentage with private health insurance coverage 

increased from the last 6 months of 2010 through the last 6 months of 2012 (52.0% to 

57.9%), after decreasing from the first 6 months of 2008 through the last 6 months of 2010 

(57.7% to 52.0%) (Figure 1).

• Among young adults aged 19–25, the percentage who were uninsured decreased from 

the last 6 months of 2010 through the last 6 months of 2012 (33.3% to 26.4%), after 

significantly increasing from the first 6 months of 2008 through the last 6 months of 2010 

(29.9% to 33.3%).

• The percentage of young adults with public coverage increased from the first 6 months of 

2008 to the last 6 months of 2010 (12.9% to 15.3%) but remained stable from the last 6 

months of 2010 to the last 6 months of 2012.

The percentage of privately insured young adults aged 19–25 who had a 

gap in coverage in the past 12 months has decreased.

• In the last 6 months of 2010, 9.7% of young adults aged 19–25 had been uninsured at some 

time in the past 12 months. This percentage increased sharply to 13.2% in the first 6 months 

of 2011, but by the last 6 months of 2012 it had been cut in half to 6.7% (Figure 2). 

• In contrast, the percentage of adults aged 26–34 who had been uninsured at some time in the 

past 12 months remained stable from 2008 through 2012.

• For each 6-month interval from January–June 2008 through January–June 2011, the 

percentage of adults who had been uninsured at some time in the past 12 months was 

significantly higher among those aged 19–25 compared with those aged 26–34. From July–

December 2011 to July–December 2012, the two age groups did not differ significantly.

Figure 2. Percentages of privately insured adults aged 19–34 who were uninsured at some point in the past 12 months, by 

age group and 6-month interval: United States, 2008–2012

1

Significant linear trend from January–June 2008 through July–December 2010 (p < 0.05).

2

Significant linear trend from July–December 2010 through July–December 2012 (p < 0.05).

NOTE: Data are based on household interviews of a sample of the civilian noninstitutionalized population.

SOURCE: CDC/NCHS, National Health Interview Survey, 2008–2012. Percent

0

2

4

6

8

10

12

14

26–34 years

19–25 years1,2

Jul–Dec

2012

Jan–Jun

2012

Jul–Dec

2011

Jan–Jun

2011

Jul–Dec

2010

Jan–Jun

2010

Jul–Dec

2009

Jan–Jun

2009

Jul–Dec

2008

Jan–Jun 

2008

Expansion of private health insurance 

coverage for dependents aged 19–25
NCHS Data Brief ■ No. 137 ■ December 2013

■  3  ■

The percentage of young adults who are the policyholders for their private 

coverage has decreased.

• Privately insured young adults aged 19–25 were less likely to have coverage in their own 

names in the last 6 months of 2012 (27.2%) compared with the last 6 months of 2010 

(40.8%) (Figure 3). 

• The proportion of privately insured young adults who obtained their coverage through some 

other family member increased by 14 percentage points (59.2% in the last 6 months of 2010 

to 72.8% in the last 6 months of 2012). This came after a slight increase from the first

6 months of 2008 to the last 6 months of 2010 (55.6% to 59.2%).

Figure 3. Percentages of privately insured adults aged 19–25, by policyholder and 6-month interval: United States, 

2008–2012

1

Significant linear trend from January–June 2008 through July–December 2010 (p < 0.05).

2

Significant linear trend from July–December 2010 through July–December 2012 (p < 0.05).

NOTE: Data are based on household interviews of a sample of the civilian noninstitutionalized population.

SOURCE: CDC/NCHS, National Health Interview Survey, 2008–2012.

10

0

20

30

40

50

60

70

80

Other family member1,2

Own name1,2

Expansion of private health insurance 

coverage for dependents aged 19–25

Percent

Jul–Dec

2012

Jan–Jun

2012

Jul–Dec

2011

Jan–Jun

2011

Jul–Dec

2010

Jan–Jun

2010

Jul–Dec

2009

Jan–Jun

2009

Jul–Dec

2008

Jan–Jun 

2008
NCHS Data Brief ■ No. 137 ■ December 2013

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The percentage of privately insured young adults with employer-sponsored 

coverage has increased since the last 6 months of 2010.

• Among privately insured young adults aged 19–25, the percentage with employer-sponsored 

health insurance was stable from the first 6 months of 2008 through the last

6 months of 2010 but then increased from 85.6% in the last 6 months of 2010 to 92.5% in 

the last 6 months of 2012 (Figure 4).

• By comparison, a decreasing trend was apparent in the percentage of adults aged 26–34

with employer-sponsored health insurance from the first 6 months of 2008 through the last

6 months of 2010 (93.8% to 91.8%), but the percentages remained stable from the last

6 months of 2010 through the last 6 months of 2012.

• For each 6-month interval from January–June 2008 through January–June 2011, the 

percentage of adults with employer-sponsored health insurance was significantly lower 

among those aged 19–25 compared with those aged 26–34. From July–December 2011 to 

July–December 2012, the two age groups did not differ significantly.

Figure 4. Percentages of privately insured adults aged 19–34 with employer-sponsored health insurance, by 6-month

interval: United States, 2008–2012

Jul–Dec

2012

Jan–Jun

2012

Jul–Dec

2011

Jan–Jun

2011

Jul–Dec

2010

Jan–Jun

2010

Jul–Dec

2009

Jan–Jun

2009

Jul–Dec

2008

Jan–Jun 

2008

1

Significant linear trend from January–June 2008 through July–December 2010 (p < 0.05).

2

Significant linear trend from July–December 2010 through July–December 2012 (p < 0.05).

NOTES: Data are based on household interviews of a sample of the civilian noninstitutionalized population. Employer-sponsored health insurance may be through 

the young adult’s own employer or through a parent’s employer.

SOURCE: CDC/NCHS, National Health Interview Survey, 2008–2012.

0

84

86

88

90

92

94

96

26–34 years1

19–25 years

Percent

2

Expansion of private health insurance 

coverage for dependents aged 19–25

Summary

This report shows that since September 2010, when young adults aged 19–25 were able to obtain 

dependent private health insurance coverage through a provision of the ACA, the percentage of 

young adults with private insurance increased and the percentage without insurance decreased. 

The increase in the percentage with private insurance occurred at about the same time (January–

June 2011) as a temporary increase in the percentage of privately insured young adults who 

had been uninsured at some time in the past 12 months. This suggests that those newly insured 

were previously uninsured or had a period of no insurance in the past year. After this spike, the 

percentage of young adults with a period of no insurance did not return to pre-2011 levels but 
NCHS Data Brief ■ No. 137 ■ December 2013

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rather declined to levels consistent with slightly older adults.

Since September 2010, the percentage of young adults who obtained coverage through some 

other family member increased, and the percentage of young adults with coverage sponsored 

through the employer of the policyholder (the parent or the young adult) increased. Additional 

research is needed to determine the extent to which the increase in dependent coverage among 

the privately insured reflects the acquisition of dependent coverage among the uninsured or the 

substitution of dependent coverage for self-coverage.

Definitions

Having a period of uninsurance in the last 12 months: Determined by the question, “In the past 12 

months, was there any time when [person] did not have any health insurance or coverage?”

Policyholder: Identified by the question, “Health insurance plans are usually obtained in one 

person’s name even if other family members are covered. That person is called the policyholder. 

In whose name is this plan?” The answer categories, “in own name,” “someone else in family,” 

and “person not in household,” are mutually exclusive. 

Other family member: Determined by the question, “Health insurance plans are usually obtained 

in one person’s name even if other family members are covered. That person is called the 

policyholder. In whose name is this plan?” The answer categories, “in own name,” “someone 

else in family,” and “person not in household,” are mutually exclusive. “Other family member” 

includes “someone else in family” and “person not in household.” 

Employer-sponsored coverage: Determined by the question, “Which one of these categories 

best describes how this plan was obtained?” A respondent is considered to have employersponsored coverage if the coverage was originally obtained through a present or former employer, 

workplace, union, or professional association. Employer-sponsored coverage could be through the 

young adult’s own employment or through a parent’s employer.

Data source and methods

Data from the 2008–2012 NHIS were used for this analysis. Interviewers from the U.S. 

Census Bureau collect NHIS data continuously throughout the year for the Centers for Disease 

Control and Prevention’s (CDC) National Center for Health Statistics (NCHS). NHIS collects 

information about the health and health care of the civilian noninstitutionalized U.S. population. 

Interviews are conducted in respondents’ homes, but follow-ups to complete interviews may be 

conducted over the telephone. Questions about health insurance coverage are from the Family 

Core component, which collects information on all family members. This analysis included only 

adults aged 19–34. In 2008–2012, data were collected on 42,507 persons aged 19–25 and 55,403 

persons aged 26–34. For further information about NHIS, including the questionnaire, see the 

NHIS website: http://www.cdc.gov/nchs/nhis.htm.

NHIS is designed to yield a sample representative of the civilian noninstitutionalized population 

of the United States, and weights are used to produce national estimates. Data weighting 

procedures are described in more detail elsewhere (5). Point estimates, estimates of corresponding 

variances, and logistic regression models for trend analysis were calculated using SUDAAN 
NCHS Data Brief ■ No. 137 ■ December 2013

■  6  ■

software (6) to account for the complex sample design of NHIS. The Taylor series linearization 

method was chosen for variance estimation. All estimates shown in this report meet the NCHS 

standard of reliability (relative standard error less than or equal to 30%). Differences between 

percentages were evaluated using two-sided significance tests at the 0.05 level. Terms such as 

“increased,” “decreased,” and “higher than” indicate statistically significant trends or differences. 

Terms such as “remained stable” and “no difference” indicate trends or comparisons that were not 

significantly different. Lack of comment regarding the difference between any two statistics does 

not necessarily suggest that the difference was tested and found not to be significant.

About the authors

Whitney K. Kirzinger, Robin A. Cohen, and Renee M. Gindi are with CDC’s National Center for

 Health Statistics, Division of Health Interview Statistics.

References

1. Cohen RA, Martinez ME. Health insurance coverage: Early release of estimates from the 

National Health Interview Survey, 2012. Hyattsville, MD: National Center for Health Statistics. 

2013. Available from: http://www.cdc.gov/nchs/data/nhis/earlyrelease/insur201306.pdf.

2. Short PF, Graefe DR, Swartz K, Uberoi N. New estimates of gaps and transitions in health 

insurance. Med Care Res Rev 69(6):721–36. 2012.

3. Sommers BD, Kronick R. The Affordable Care Act and insurance coverage for young adults. 

JAMA 307(9):913–4. 2012.

4. Schwartz K, Sommers BD. Young adults are particularly likely to gain stable health 

insurance coverage as a result of the Affordable Care Act. ASPE research brief. Washington, 

DC: U.S. Department of Health and Human Services, Office of the Assistant Secretary for 

Planning and Evaluation. 2012. Available from: http://aspe.hhs.gov/health/reports/2012/

UninsuredYoungAdults/rb.shtml.

5. Botman SL, Moore TF, Moriarity CL, Parsons VL. Design and estimation for the National 

Health Interview Survey, 1995–2004. National Center for Health Statistics. Vital Health Stat 

2(130). 2000. 

6. RTI International. SUDAAN (Release 10.0) [computer software]. 2008. Available from: 

http://www.rti.org/SUDAAN/. 
NCHS Data Brief ■ No. 137 ■ December 2013

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NCHS Data Brief ■ No. 137 ■ December 2013

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Suggested citation

Kirzinger WK, Cohen RA, Gindi RM. 

Trends in insurance coverage and source of 

private coverage among young adults aged 

19–25: United States, 2008–2012. NCHS 

data brief, no 137. Hyattsville, MD: National 

Center for Health Statistics. 2013.

Copyright information

All material appearing in this report is in 

the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated.

National Center for Health 

Statistics

Charles J. Rothwell, M.S., Acting Director

Jennifer H. Madans, Ph.D., Associate 

Director for Science

Division of Health Interview Statistics

Jane F. Gentleman, Ph.D., Director

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