The effect of the Affordable Care Act Medicaid expansion on marriage

Hampton, Matt and Lenhart, Otto (2022) The effect of the Affordable Care Act Medicaid expansion on marriage. Economic Inquiry, 60 (2). pp. 568-591. ISSN 1465-7295 (https://doi.org/10.1111/ecin.13052)

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Abstract

This paper investigates the impact of the Affordable Care Act Medicaid expansions on marital behavior. We use data from the American Community Survey from 2008 to 2019 and estimate difference-in-differences models to test for effects on marriage and divorce outcomes. We find that expansions led to a 0.95% reduction in marriage stock and a 2.22% increase in divorce stock, with effects being larger among low educated individuals. We believe that two factors play a role as underlying mechanisms: (1) reduced reliance on spousal insurance coverage and (2) deciding to forego marriage or get divorced to meet eligibility restrictions.

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