Until Insurance Do Us Part? : The Impact of the Affordable Care Act on Marriage and Divorce Decisions

Background: Marital decision-making is affected by policies that impact the costs and benefits of marriage. Access to health insurance through dependent coverage is a benefit of marriage that a substantial part of the population avails of. However, policies that change eligibility criteria and costs of alternative sources of insurance can affect marital decisions. The Affordable Care Act with its aim to provide universal coverage instituted a series of provisions that affected the costs of various sources of health insurance coverage.

Aim: This study aims to causally estimate the impact of the 2014 Medicaid expansion of the ACA, on the likelihood of marriage and divorce. By doing so, I additionally try to address the possibility of the incidence of “marriage-lock” whereby individuals decide to marry or stay married for availing dependent coverage through their spouse’s health insurance.

Method: I use data from the American Community Survey(ACS) to study the causal impact of the Medicaid Expansions of 2014 under the Affordable Care Act on marriage and divorce decisions. The ACS records variables which enables me to identify new marriage initiations and terminations instead of just the stock of married or divorced. I employ difference-in-differences estimates to particularly look at the impact of Medicaid expansion on marital decisions using variation in time and state Medicaid expansion status.

Preliminary Results: Medicaid expansion does have an impact on the marital decisions of people in the age-group of 27-35. One of the possible pathways can be a substitution effect on marriage whereby affordable alternatives to dependent health coverage, encourages people to seek insurance outside of marriage, thus reducing the relative benefit of marriage. I do not find any impact on divorces. Results suggest considerable heterogeneity in effects among various groups and the importance of understanding the diverse pathways through which the Medicaid expansion can impact marital decisions of different groups of people.