Health Insurance and Marriage Behavior: Will Marriage Lock Hold under Healthcare Reform?

Subsidies, taxes, premiums, and eligibility for health insurance can potentially cause “marriage lock,” in which couples stay married for the sake of health insurance coverage, and marriage lock may change under the healthcare reform. In this paper, I examine marriage lock through marriage and divorce decisions caused by the introduction of the Massachusetts insurance mandate and health insurance exchange market under the 2006 healthcare reform. Using American Community Survey data, I examine how marriage behavior changed when the health insurance exchange market and individual mandate were introduced to Massachusetts in 2006 relative to control states. I find that the 2006 Massachusetts healthcare reform increased incentives for marriage in the health insurance exchanges market relative to control states. Specifically, the Massachusetts reform appears to have reduced the divorce rate by 0.5 percentage point and increased marriage rate by 1.4 percentage points. My estimates in the paper provide some evidence that “marriage lock” exists and further suggest that health insurance coverage could serve as a marriage lock and the price of health insurance also plays an important role.