07/02/18  Portland, Ore.

Written by Heather Holderness (OHSU Family Medicine), Heather Angier (OHSU Family Medicine), William Pinnock (OCHIN)

Transitioning to adulthood is a time of great social, economic, and personal changes and challenges for many adolescents. One change often forgotten about is how to navigate health insurance coverage. "How does one enroll? Who can provide assistance? Where do I enroll?" are not uncommon questions when trying to understand the world of health insurance.

So, what happens to adolescents who are covered by public health insurance as they transition to adulthood? Are they able to retain their health insurance? What are the rates of insurance loss during this transition?  To answer these questions, Oregon Health &Science University and OCHIN recently teamed up on a research study to gain a clearer picture of what is happening to Oregon adolescents with public health insurance who are transitioning to adulthood.

Answering these questions required data, so we contacted the Oregon Health Plan (OHP) and were able to collect data they had from Medicaid and the Children's Health Insurance Program (CHIP). Once we had this data, we linked it to the electronic health record (EHR) data from the OCHIN community health center network. In total, we studied 52,000 Oregon adolescents (aged 17 to 19 years).   

Through our analysis, we found that 19 year olds lost coverage at much higher rates than 17 or 18 year olds. Yet, more than 35 percent of 19-year olds were able to maintain coverage for up to one year after their 19th birthday. Hispanic 19 year olds were more likely to lose coverage than non-Hispanic whites, but those seen in OCHIN community health centers were less likely to lose coverage.

Overall, this study suggests that community health centers offer support to help adolescents maintain health insurance coverage. 

During a time of significant transition and change for adolescents, especially those who may already be facing personal and familial challenges, attention from their healthcare team to help them navigate the public health insurance system could be one less stressor in their lives. 

Healthcare teams should keep this in mind when consulting with their patients as they transition from adolescence to adulthood.