The Effect of the ACA Medicaid Expansion on Marriage Behavior

37 Pages Posted: 18 Sep 2019 Last revised: 18 Dec 2020

See all articles by Matt Hampton

Matt Hampton

University of Northern Iowa - College of Business Administration - Department of Economics

Otto Lenhart

University of Strathclyde - Strathclyde Business School

Date Written: September 9, 2019

Abstract

paper investigates the impact of the 2014 Medicaid expansions on marital behavior. The Patient Protection and Affordable Care Act (ACA) encouraged states to expand Medicaid and thereby increase insurance options for low-income individuals. Contributing to earlier work showing evidence of a link between insurance coverage and incentives to marry, we test whether the Medicaid expansions affected marriage and divorce decisions. Using data from the American Community Survey from 2008 to 2018 and estimating difference-in-differences models, we test the impact of Medicaid expansion on both stock and flow marital outcomes. As a first-stage effect, we show that the expansions increased Medicaid coverage by 31.15 percent in first-time expansion states. When evaluating the effects of the policy on marriage behavior, we find that Medicaid expansions led to a 0.75 percent reduction in the stock of married people, a 4.15 percent reduction in the likelihood of having married in the past year, and a 3.61 percent increase in having had a recent divorce. We believe the underlying mechanism to be twofold. First, Medicaid expansion led to increased insurance options, which decreased reliance on spousal health insurance coverage. Second, by changing eligibility thresholds, Medicaid led to people choosing to forego marriage or get divorced to meet post-policy program eligibility restrictions.

Keywords: Affordable Care Act, Medicaid Expansion, Health Insurance, Marriage

JEL Classification: J12, I13, D1

Suggested Citation

Hampton, Matt and Lenhart, Otto, The Effect of the ACA Medicaid Expansion on Marriage Behavior (September 9, 2019). Available at SSRN: https://ssrn.com/abstract=3450609 or http://dx.doi.org/10.2139/ssrn.3450609

Matt Hampton

University of Northern Iowa - College of Business Administration - Department of Economics ( email )

Cedar Falls, IA 50614
United States

Otto Lenhart (Contact Author)

University of Strathclyde - Strathclyde Business School ( email )

100 Cathedral Street
Glasgow G1 1XU
United Kingdom

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