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The effect of the Affordable Care Act preexisting conditions provision on marriage

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  • Matt Hampton
  • Otto Lenhart

Abstract

This paper investigates the effect of the Affordable Care Act preexisting conditions provision on marriage. The policy was implemented to prevent insurers from denying insurance coverage to individuals with preexisting health conditions. We test whether the implementation of the provision led to decreases in marriage among affected adults. We add to earlier work on how marital behavior is influenced by spousal health insurance and examine for the presence of “marriage lock,” a situation in which individuals remain married primarily for insurance. Using longitudinal data from the Panel Study of Income Dynamics from 2009 to 2017 and estimating difference‐in‐differences models, we find that male household heads with preexisting conditions are 7.12 percentage points (8.9 percent) less likely to be married after the policy. Using information on insurance status prior to the policy change, we find significant reductions in marriage among individuals with preexisting conditions who were previously insured by spousal health insurance plans. The findings suggest that the inability to attain individual coverage and reliance on spousal insurance provided incentives to remain married before 2014.

Suggested Citation

  • Matt Hampton & Otto Lenhart, 2019. "The effect of the Affordable Care Act preexisting conditions provision on marriage," Health Economics, John Wiley & Sons, Ltd., vol. 28(11), pages 1345-1355, November.
    • Handle: RePEc:wly:hlthec:v:28:y:2019:i:11:p:1345-1355
    DOI: 10.1002/hec.3947
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    References listed on IDEAS

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    1. David J. G. Slusky & Donna K. Ginther, 2021. "Did Medicaid expansion reduce medical divorce?," Review of Economics of the Household, Springer, vol. 19(4), pages 1139-1174, December.
    2. Laura Connolly & Matt Hampton & Otto Lenhart, 2024. "Labor mobility and the Affordable Care Act: Heterogeneous impacts of the preexisting conditions provision," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 43(1), pages 157-191, January.
    3. Matt Hampton & Otto Lenhart, 2022. "Access to health care and mental health—Evidence from the ACA preexisting conditions provision," Health Economics, John Wiley & Sons, Ltd., vol. 31(5), pages 760-783, May.
    4. Aparna Soni & Taryn Morrissey, 2022. "The effects of Medicaid expansion on home production and childcare," Southern Economic Journal, John Wiley & Sons, vol. 88(3), pages 931-950, January.
    5. Christal Hamilton, 2024. "The impact of the 2014 Medicaid expansion on the health, health care access, and financial well‐being of low‐income young adults," Health Economics, John Wiley & Sons, Ltd., vol. 33(8), pages 1895-1925, August.
    6. Margaret E. Blume-Kohout, 2024. "Entrepreneurship Lock and the Demand for Health Insurance: Evidence from the US Affordable Care Act," ILR Review, Cornell University, ILR School, vol. 77(2), pages 199-226, March.
    7. Matt Hampton & Otto Lenhart, 2022. "The effect of the Affordable Care Act Medicaid expansion on marriage," Economic Inquiry, Western Economic Association International, vol. 60(2), pages 568-591, April.

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