Research

The Dependent Coverage Mandate (DCM), enacted as part of the Affordable Care Act in 2010, substantially expanded health insurance coverage among young adults, a population that is both chronically uninsured and disproportionately at risk for intimate partner violence (IPV). In the United States, nearly three-quarters of female IPV survivors were first victimized before age 25, and the lifetime costs of IPV victimization are estimated at $3.65 trillion (2019 dollars). We are the first to study the impact of the DCM on IPV victimization. Using a difference-in-differences design and data from the FBI's National Incident-Based Reporting System for 2008–2013, we find that the DCM reduced IPV victimization among young women ages 22–25 by approximately 4.5 percent relative to women ages 27–29. A mechanisms analysis, drawing on data from the SIPP, MEPS, NHIS, and TEDS, points to three main short-term channels: fewer incentive for age-disparate partnerships, improvements in women's financial stability through reduced out-of-pocket health spending and lower reliance on public assistance, and increased residential proximity to parents. Additional age-specific analyses provide no evidence of a delayed increase or displacement of IPV after women age out of dependent coverage. These findings are robust to a battery of specification checks and are reinforced by a triple-differences strategy exploiting geographic variation in pre-DCM uninsured rates. Back-of-the-envelope calculations suggest the DCM generated $282 million in annual cost savings from IPV reduction alone, underscoring the broad social value of expanding coverage to young adults.